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Pellicanò GF, Squeri A, Ciappina G, Squeri R, Palmara VI, Parisi S, Campo I, Saitta C, Rossanese M, Di Trapani E, Mancuso S, Catalano N, Allegra A, Mancuso G, Murolo G, Bignucolo A, Restivo DA, Consolo P, Berretta M. Proposal of model for personalized early adapted cancer screening in people living with HIV: experience of "Gaetano Martino" Hospital University of Messina. Eur Rev Med Pharmacol Sci 2024; 28:2929-2942. [PMID: 38639530 DOI: 10.26355/eurrev_202404_35924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]
Abstract
Human immunodeficiency virus (HIV) infection has historically been related to the development of specific cancers, some of which are so closely linked to the infection, such as Kaposi's Sarcoma (KS), that they have earned the name Acquired Immuno-Deficiency Syndrome (AIDS)-defining cancers (ADCs). While the development of antiretroviral therapy (ART) has decreased the incidence of AIDS-defining cancers, the resulting aging of people living with HIV (PLWH) highlighted an increased occurrence of other forms of cancer. At the "Gaetano Martino" hospital in Messina, we developed a multidisciplinary approach by creating a bridge between the Oncology Unit and the Infectious Diseases Unit to carry out screening and a more rapid diagnostic and therapeutic journey for cancers in PLWH. The goal is to improve the diagnosis of various types of cancer by involving other professionals, such as gastroenterologists and gynecologists, to ensure faster access to treatment and, therefore, a greater chance of survival. In addition, our multidisciplinary approach has also included vaccine screening, offered by the "Gaetano Martino" hospital and useful for preventing the development of specific forms of cancer in the entire population and particularly in PLWH.
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Affiliation(s)
- G F Pellicanò
- Department of Human Pathology of Adult and Childhood "G. Barresi", University of Messina, Messina, Italy.
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Saitta C, Afari JA, Walia A, Patil D, Tanaka H, Hakimi K, Wang L, Meagher MF, Liu F, Nguyen MV, Puri D, Cerrato C, Saidian A, Kobayashi M, Fukuda S, Fujii Y, Master V, Derweesh IH. Unraveling the BMI paradox in different renal cortical tumors: insights from the INMARC registry. Urol Oncol 2024; 42:119.e1-119.e16. [PMID: 38341362 DOI: 10.1016/j.urolonc.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/19/2023] [Accepted: 11/19/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To investigate impact of body mass index (BMI) on survival across different histologies and stages of renal cell carcinoma (RCC). METHODS We conducted a retrospective multicenter analysis of clear cell (ccRCC) and non-ccRCC. Obesity was defined according to the WHO criteria (non-Asian BMI >30 Kg/m2, Asian BMI >27.5 Kg/m2). Multivariable analysis (MVA) via Cox regression model was conducted for all-cause (ACM), cancer-specific mortality (CSM) and recurrence. RESULTS A total of 3,880 patients with a median follow-up of 31 (IQR 9-64) months were analyzed. Overall, 1,373 (35.3%) were obese; 2,895 (74.6%) were ccRCC and 985 (25.3%) were non-ccRCC (chRCC 246 [24.9%], pRCC 469 [47.6%] and vhRCC 270 [27.4%]). MVA in ccRCC revealed obesity associated with decreased risk of ACM, CSM and recurrence (hazard ratio [HR] 0.80, P = 0.044; HR 0.71, P = 0.039; HR 0.73, P = 0.012, respectively), while in non-ccRCC was not associated with decreased risk of ACM, CSM, and recurrence (P = 0.84, P = 0.53, P = 0.84, respectively). Subset analysis in stage IV ccRCC demonstrated obesity as associated with a decreased risk of ACM, CSM, and recurrence (HR 0.68, P = 0.04; HR 0.59, P = 0.01; HR 0.59, P = 0.01, respectively), while in stage I-III ccRCC was not (P = 0.21; P = 0.30; P = 0.19, respectively). CONCLUSION Our findings refute a broad "obesity paradox" for RCC. Obesity was not associated with improved survival in non-ccRCC and in nonmetastatic ccRCC, while metastatic ccRCC patients with obesity had improved survival outcomes.
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Affiliation(s)
- Cesare Saitta
- Department of Urology, UC San Diego Health System, San Diego, CA
| | - Jonathan A Afari
- Department of Urology, UC San Diego Health System, San Diego, CA
| | - Arman Walia
- Department of Urology, UC San Diego Health System, San Diego, CA
| | | | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kevin Hakimi
- Department of Urology, UC San Diego Health System, San Diego, CA
| | - Luke Wang
- Department of Urology, UC San Diego Health System, San Diego, CA
| | | | - Franklin Liu
- Department of Urology, UC San Diego Health System, San Diego, CA
| | - Mimi V Nguyen
- Department of Urology, UC San Diego Health System, San Diego, CA
| | - Dhruv Puri
- Department of Urology, UC San Diego Health System, San Diego, CA
| | - Clara Cerrato
- Department of Urology, UC San Diego Health System, San Diego, CA
| | - Ava Saidian
- Department of Urology, UC San Diego Health System, San Diego, CA
| | - Masaki Kobayashi
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shohei Fukuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Viraj Master
- Department of Urology, Emory Medical Center, Atlanta, GA
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Beatrici E, Frego N, Chiarelli G, Sordelli F, Mancon S, Saitta C, De Carne F, Garofano G, Arena P, Avolio PP, Gobbo A, Uleri A, Contieri R, Paciotti M, Lazzeri M, Hurle R, Casale P, Buffi NM, Lughezzani G. A Comparative Evaluation of Multiparametric Magnetic Resonance Imaging and Micro-Ultrasound for the Detection of Clinically Significant Prostate Cancer in Patients with Prior Negative Biopsies. Diagnostics (Basel) 2024; 14:525. [PMID: 38472997 DOI: 10.3390/diagnostics14050525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 02/25/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The diagnostic process for prostate cancer after a negative biopsy is challenging. This study compares the diagnostic accuracy of micro-ultrasound (mUS) with multiparametric magnetic resonance imaging (mpMRI) for such cases. METHODS A retrospective cohort study was performed, targeting men with previous negative biopsies and using mUS and mpMRI to detect prostate cancer and clinically significant prostate cancer (csPCa). RESULTS In our cohort of 1397 men, 304 had a history of negative biopsies. mUS was more sensitive than mpMRI, with better predictive value for negative results. Importantly, mUS was significantly associated with csPCa detection (adjusted odds ratio [aOR]: 6.58; 95% confidence interval [CI]: 1.15-37.8; p = 0.035). CONCLUSIONS mUS may be preferable for diagnosing prostate cancer in previously biopsy-negative patients. However, the retrospective design of this study at a single institution suggests that further research across multiple centers is warranted.
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Affiliation(s)
- Edoardo Beatrici
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Nicola Frego
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Giuseppe Chiarelli
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Federica Sordelli
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Stefano Mancon
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Cesare Saitta
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Fabio De Carne
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Giuseppe Garofano
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Paola Arena
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Pier Paolo Avolio
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Andrea Gobbo
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Alessandro Uleri
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Roberto Contieri
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Marco Paciotti
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Rodolfo Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Nicolò Maria Buffi
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
| | - Giovanni Lughezzani
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, MI, Italy
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Avolio PP, Lazzeri M, Maffei D, Fasulo V, Frego N, Saitta C, de Carne F, Paciotti M, Saita A, Hurle R, Guazzoni G, Casale P, Buffi NM, Lughezzani G. Is multiparametric MRI always needed in biopsy-naïve patients with abnormal digital rectal examination? A single-institutional experience combining clinical and micro-ultrasonography-based factors to optimize prostate cancer detection. World J Urol 2024; 42:9. [PMID: 38183489 DOI: 10.1007/s00345-023-04722-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/16/2023] [Indexed: 01/08/2024] Open
Abstract
PURPOSE To assess the diagnostic performance of microultrasound-targeted biopsy (microUSTBx) and systematic biopsy (SBx) in detecting clinically significant prostate cancer (csPCa) among men with abnormal digital rectal examination (DRE) and suspicious lesions at multiparametric magnetic resonance imaging (mpMRI), and to compare the diagnostic performance of this approach with a mpMRI-guided targeted biopsy (MTBx) plus SBx-based strategy. METHODS Biopsy-naïve men with suspicious lesions at mpMRI and abnormal DRE were prospectively evaluated between October 2017 and January 2023. csPCa detection rate by microUSTBx plus SBx and MTBx plus SBx was assessed and then compared by McNemar's test. The added value of prostate-specific antigen density (PSAd) was also evaluated. RESULTS Overall, 182 biopsy naïve men were included. MicroUSTBx plus SBx achieved comparable detection rate to MTBx plus SBx in diagnosis of ciPCa and csPCa (ciPCa: 9.3% [17/182] vs 10% [19/182]; csPCa: 63% [114/182] vs 62% [113/182]). MicroUSTBx outperformed MTBx (ciPCa: 5.5% [10/182] vs 6.0% [11/182]; csPCa: 57% [103/182] vs 54% [99/182]). Using microUSTBx plus SBx would have avoided 68/182 (37%) unnecessary mpMRI, while missing only 2/116 (1.7%) csPCa. The decision curve analysis of suspicious microUS plus PSAd ≥ 0.15 ng/ml showed higher net benefit in the ability to identify true positives and reduce the number of unnecessary prostate biopsy in this subcategory of patients. CONCLUSIONS The combination of microUSTBx and SBx showed equal diagnostic performance to an mpMRI-based approach in biopsy-naïve patients with an abnormal DRE. The combination of this approach with PSAd maximize the diagnostic accuracy while lowering the need for unnecessary biopsies.
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Affiliation(s)
- Pier Paolo Avolio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Rozzano, 20090, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Davide Maffei
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Rozzano, 20090, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Vittorio Fasulo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Rozzano, 20090, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Nicola Frego
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Rozzano, 20090, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Cesare Saitta
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Rozzano, 20090, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Fabio de Carne
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Rozzano, 20090, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Marco Paciotti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Rozzano, 20090, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Alberto Saita
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Rodolfo Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Giorgio Guazzoni
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Rozzano, 20090, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Nicolò Maria Buffi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Rozzano, 20090, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy
| | - Giovanni Lughezzani
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Rozzano, 20090, Milan, Italy.
- Department of Urology, IRCCS Humanitas Research Hospital, via Manzoni 56, Rozzano, 20089, Milan, Italy.
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5
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Saitta C, Afari JA, Autorino R, Capitanio U, Porpiglia F, Amparore D, Piramide F, Cerrato C, Meagher MF, Noyes SL, Pandolfo SD, Buffi NM, Larcher A, Hakimi K, Nguyen MV, Puri D, Diana P, Fasulo V, Saita A, Lughezzani G, Casale P, Antonelli A, Montorsi F, Lane BR, Derweesh IH. Development of a novel score (RENSAFE) to determine probability of acute kidney injury and renal functional decline post surgery: A multicenter analysis. Urol Oncol 2023; 41:487.e15-487.e23. [PMID: 37880003 DOI: 10.1016/j.urolonc.2023.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/15/2023] [Accepted: 09/25/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE To create and validate 2 models called RENSAFE (RENalSAFEty) to predict postoperative acute kidney injury (AKI) and development of chronic kidney disease (CKD) stage 3b in patients undergoing partial (PN) or radical nephrectomy (RN) for kidney cancer. METHODS Primary objective was to develop a predictive model for AKI (reduction >25% of preoperative eGFR) and de novo CKD≥3b (<45 ml/min/1.73m2), through stepwise logistic regression. Secondary outcomes include elucidation of the relationship between AKI and de novo CKD≥3a (<60 ml/min/1.73m2). Accuracy was tested with receiver operator characteristic area under the curve (AUC). RESULTS AKI occurred in 452/1,517 patients (29.8%) and CKD≥3b in 116/903 patients (12.8%). Logistic regression demonstrated male sex (OR = 1.3, P = 0.02), ASA score (OR = 1.3, P < 0.01), hypertension (OR = 1.6, P < 0.001), R.E.N.A.L. score (OR = 1.2, P < 0.001), preoperative eGFR<60 (OR = 1.8, P = 0.009), and RN (OR = 10.4, P < 0.0001) as predictors for AKI. Age (OR 1.0, P < 0.001), diabetes mellitus (OR 2.5, P < 0.001), preoperative eGFR <60 (OR 3.6, P < 0.001) and RN (OR 2.2, P < 0.01) were predictors for CKD≥3b. AUC for RENSAFE AKI was 0.80 and 0.76 for CKD≥3b. AKI was predictive for CKD≥3a (OR = 2.2, P < 0.001), but not CKD≥3b (P = 0.1). Using 21% threshold probability for AKI achieved sensitivity: 80.3%, specificity: 61.7% and negative predictive value (NPV): 88.1%. Using 8% cutoff for CKD≥3b achieved sensitivity: 75%, specificity: 65.7%, and NPV: 96%. CONCLUSION RENSAFE models utilizing perioperative variables that can predict AKI and CKD may help guide shared decision making. Impact of postsurgical AKI was limited to less severe CKD (eGFR<60 ml/min 71.73m2). Confirmatory studies are requisite.
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Affiliation(s)
- Cesare Saitta
- University of California: San Diego Health System, San Diego, CA; Department of Urology, IRCCS Humanitas Clinical and Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Jonathan A Afari
- University of California: San Diego Health System, San Diego, CA
| | | | - Umberto Capitanio
- Department of Urology, San Raffaele Scientific Institute, Milan, Italy
| | - Francesco Porpiglia
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Daniele Amparore
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Federico Piramide
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy
| | - Clara Cerrato
- University of California: San Diego Health System, San Diego, CA; Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Sabrina L Noyes
- Spectrum Health, Grand Rapids, Michigan State University College of Human Medicine, Grand Rapids, MI
| | | | - Nicolò M Buffi
- Department of Urology, IRCCS Humanitas Clinical and Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | | | - Kevin Hakimi
- University of California: San Diego Health System, San Diego, CA
| | - Mimi V Nguyen
- University of California: San Diego Health System, San Diego, CA
| | - Dhruv Puri
- University of California: San Diego Health System, San Diego, CA
| | - Pietro Diana
- Department of Urology, IRCCS Humanitas Clinical and Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Vittorio Fasulo
- Department of Urology, IRCCS Humanitas Clinical and Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Alberto Saita
- Department of Urology, IRCCS Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Giovanni Lughezzani
- Department of Urology, IRCCS Humanitas Clinical and Research Hospital, Rozzano, Italy; Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Clinical and Research Hospital, Rozzano, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | | | - Brian R Lane
- Spectrum Health, Grand Rapids, Michigan State University College of Human Medicine, Grand Rapids, MI
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6
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Gobbo A, Fasulo V, Contieri R, Uleri A, Avolio PP, Frego N, Lughezzani G, Saitta C, Taverna G, Zanoni M, Mancon S, Colombo P, Valeri M, Saita A, Lazzeri M, Buffi NM, Hurle R, Casale P. Clinical and pathological predictors of persistent T1 HG at second resection. Urologia 2023:3915603231181619. [PMID: 37341094 DOI: 10.1177/03915603231181619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND T1 high-grade (HG) non-muscle invasive bladder cancer (NMIBC) has a significant risk of recurrence and progression, and the European Association of Urology recommends a second transurethral resection of the bladder (ReTUR). Stage at ReTUR has been shown to be a reliable predictor of survival, therefore, we sought to assess clinical and pathological predictors associated with the persistence of T1 at ReTUR in our retrospective multicentric cohort. METHODS This is a retrospective multicentric study of T1 HG patients at transurethral resection of the bladder (TURB) who underwent subsequent ReTUR. All histological samples were sub-classified according to Rete Oncologica Lombarda (ROL) T1 sub-staging system. RESULTS One hundred and sixty-six patients were enrolled. Forty-four (26.5%) had T1 HG tumor at ReTUR while 93 (56%) had residual tumor of any stage. Lesion size was significantly greater in T1 HG patients at ReTUR, as well as the prevalence of multifocality. The multivariable logistic regression model showed lesion dimension and multifocality as predictors of T1 HG at ReTUR, after adjusting for significant covariables (CIS and detrusor muscle presence). ROL sub-staging system was not a significant predictor, but ROL2 prevalence was higher in the T1 HG at ReTUR group. CONCLUSIONS Lesion size and multifocality were independent predictors of T1 HG persistence at ReTUR, and patients at risk should be promptly identified and treated accordingly. Our results could help physicians make patient-tailored decisions by identifying those most likely to benefit from a second resection.
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Affiliation(s)
- Andrea Gobbo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Vittorio Fasulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Roberto Contieri
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alessandro Uleri
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Pier Paolo Avolio
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Nicola Frego
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giovanni Lughezzani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Cesare Saitta
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Gianluigi Taverna
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Urology Unit, Humanitas Mater Domini, Castellanza, Varese, Italy
| | - Matteo Zanoni
- Urology Unit, Humanitas Mater Domini, Castellanza, Varese, Italy
| | - Stefano Mancon
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Piergiuseppe Colombo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Pathology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italia
| | - Marina Valeri
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Pathology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italia
| | - Alberto Saita
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Nicolò M Buffi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Rodolfo Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Saitta C, De Simone I, Fasulo V, Corbetta M, Duga S, Chiereghin C, Colombo FS, Benetti A, Contieri R, Avolio PP, Uleri A, Saita A, Guazzoni GF, Hurle R, Colombo P, Buffi NM, Casale P, Lughezzani G, Asselta R, Soldà G, Lazzeri M. Evaluation of Semen Self-Sampling Yield Predictors and CTC Isolation by Multi-Color Flow Cytometry for Liquid Biopsy of Localized Prostate Cancer. Cancers (Basel) 2023; 15:2666. [PMID: 37345004 DOI: 10.3390/cancers15102666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/01/2023] [Accepted: 05/06/2023] [Indexed: 06/23/2023] Open
Abstract
Liquid biopsy (LB) for prostate cancer (PCa) detection could represent an alternative to biopsy. Seminal fluid (SF) is a source of PCa-specific biomarkers, as 40% of ejaculate derives from the prostate. We tested the feasibility of an SF-based LB by evaluating the yield of semen self-sampling in a cohort of >750 patients with clinically localized PCa. The overall SF collection yield was 18.2% (39% when considering only compliant patients), with about a half of the patients (53.15%) not consenting to SF donation. Independent favorable predictors for SF collection were younger age and lower prostate volume. We implemented a protocol to enrich prostate-derived cells by multi-color flow cytometry and applied it on SF and urine samples from 100 patients. The number of prostate-enriched cells (SYTO-16+ PSMA+ CD45-) was variable, with higher numbers of cells isolated from SF than urine (p value < 0.001). Putative cancer cells (EpCAMhigh) were 2% of isolated cells in both specimens. The fraction of EpCAMhigh cells over prostate-enriched cells (PSMA+) significantly correlated with patient age in both semen and urine, but not with other clinical parameters, such as Gleason Score, ISUP, or TNM stage. Hence, enumeration of prostate-derived cells is not sufficient to guide PCa diagnosis; additional molecular analyses to detect patient-specific cancer lesions will be needed.
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Affiliation(s)
- Cesare Saitta
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Ilaria De Simone
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Vittorio Fasulo
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Marinella Corbetta
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Stefano Duga
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Flow Cytometry Core, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Chiara Chiereghin
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | | | - Alessio Benetti
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Roberto Contieri
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Pier Paolo Avolio
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Alessandro Uleri
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Alberto Saita
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Giorgio Ferruccio Guazzoni
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Rodolfo Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Piergiuseppe Colombo
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Department of Pathology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Nicolò Maria Buffi
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Giovanni Lughezzani
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Rosanna Asselta
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Flow Cytometry Core, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Giulia Soldà
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
- Flow Cytometry Core, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
| | - Massimo Lazzeri
- Department of Urology, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
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Meagher MF, Mir MC, Minervini A, Kriegmair M, Heck M, Porpiglia F, Van Bruwaene S, Linares E, Hevia V, D’Anna M, Veccia A, Roussel E, Claps F, Palumbo C, Marchioni M, Afari J, Saitta C, Liu F, Rubio J, Campi R, Mari A, Amiel T, Checcucci E, Musquera M, Guruli G, Pavan N, Albersen M, Antonelli A, Klatte T, Autorino R, McKay RR, Derweesh IH. Proposal for a Two-Tier Re-classification of Stage IV/M1 domain of Renal Cell Carcinoma into M1 (“Oligometastatic”) and M2 (“Polymetastatic”) subdomains: Analysis of the Registry for Metastatic Renal Cell Carcinoma (REMARCC). Front Oncol 2023; 13:1113246. [PMID: 37064092 PMCID: PMC10092360 DOI: 10.3389/fonc.2023.1113246] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 01/12/2023] [Indexed: 03/31/2023] Open
Abstract
PurposeWe hypothesized that two-tier re-classification of the “M” (metastasis) domain of the Tumor-Node-Metastasis (TNM) staging of Renal Cell Carcinoma (RCC) may improve staging accuracy than the current monolithic classification, as advancements in the understanding of tumor biology have led to increased recognition of the heterogeneous potential of metastatic RCC (mRCC).MethodsMulticenter retrospective analysis of patients from the REMARCC (REgistry of MetAstatic RCC) database. Patients were stratified by number of metastases into two groups, M1 (≤3, “Oligometastatic”) and M2 (>3, “Polymetastatic”). Primary outcome was overall survival (OS). Secondary outcomes were cancer-specific survival (CSS). Cox-regression and Kaplan-Meier (KMA) analysis were utilized for outcomes, and receiver operating characteristic analysis (ROC) was utilized to assess diagnostic accuracy compared to current “M” staging.Results429 patients were stratified into proposed M1 and M2 groups (M1 = 286/M2 = 143; median follow-up 19.2 months). Cox-regression revealed M2 classification as an independent risk factor for worsened all-cause mortality (HR=1.67, p=0.001) and cancer-specific mortality (HR=1.74, p<0.001). Comparing M1-oligometastatic vs. M2-polymetastatic groups, KMA revealed significantly higher 5-year OS (36% vs. 21%, p<0.001) and 5-year CSS (39% vs. 17%, p<0.001). ROC analyses comparing OS and CSS, for M1/M2 reclassification versus unitary M designation currently in use demonstrated improved c-index for OS (M1/M2 0.635 vs. unitary M 0.500) and CSS (M1/M2 0.627 vs. unitary M 0.500).ConclusionSubclassification of Stage “M” domain of mRCC into two clinical substage categories based on metastatic burden corresponds to distinctive tumor groups whose oncological potential varies significantly and result in improved predictive capability compared to current staging.
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Affiliation(s)
- Margaret F. Meagher
- Department of Urology, University of California (UC) San Diego School of Medicine, La Jolla, CA, United States
| | - Maria C. Mir
- Department of Urology, Fundacion Instituto Valenciano Oncologia, Valencia, Spain
| | - Andrea Minervini
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | | | - Matthias Heck
- Department of Urology, Technical University of Munich, Munich, Germany
| | - Francesco Porpiglia
- Department of Urology, University of Turin-San Luigi Gonzaga Hospital, Orbassano, Italy
| | | | | | - Vital Hevia
- Department of Urology, Hospital Ramon y Cajal, Madrid, Spain
| | - Maurizio D’Anna
- Department of Urology, Hospital Clinic, Carrer de Villarroel, Barcelona, Spain
| | - Alessandro Veccia
- Department of Urology, Virginia Commonwealth University (VCU) Medical Center, Richmond, VA, United States
| | | | - Francesco Claps
- Department of Urology, University of Trieste, Trieste, Italy
| | - Carlotta Palumbo
- Department of Urology, Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Michele Marchioni
- Department of Urology, University “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
| | - Jonathan Afari
- Department of Urology, University of California (UC) San Diego School of Medicine, La Jolla, CA, United States
| | - Cesare Saitta
- Department of Urology, University of California (UC) San Diego School of Medicine, La Jolla, CA, United States
| | - Franklin Liu
- Department of Urology, University of California (UC) San Diego School of Medicine, La Jolla, CA, United States
| | - Jose Rubio
- Department of Urology, Fundacion Instituto Valenciano Oncologia, Valencia, Spain
| | - Riccardo Campi
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Andrea Mari
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Thomas Amiel
- Department of Urology, Technical University of Munich, Munich, Germany
| | - Enrico Checcucci
- Department of Urology, University of Turin-San Luigi Gonzaga Hospital, Orbassano, Italy
| | - Mireia Musquera
- Department of Urology, Hospital Clinic, Carrer de Villarroel, Barcelona, Spain
| | - Georgi Guruli
- Department of Urology, University of Trieste, Trieste, Italy
| | - Nicola Pavan
- Department of Urology, University of Trieste, Trieste, Italy
| | | | - Alessandro Antonelli
- Department of Urology, Spedali Civili Hospital, University of Brescia, Brescia, Italy
| | - Tobias Klatte
- Department of Urology, Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - Riccardo Autorino
- Department of Urology, Virginia Commonwealth University (VCU) Medical Center, Richmond, VA, United States
| | - Rana R. McKay
- Department of Urology, University of California (UC) San Diego School of Medicine, La Jolla, CA, United States
| | - Ithaar H. Derweesh
- Department of Urology, University of California (UC) San Diego School of Medicine, La Jolla, CA, United States
- *Correspondence: Ithaar H. Derweesh,
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9
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Maffei D, Fasulo V, Avolio PP, Saitta C, Paciotti M, De Carne F, Colombo P, Pasini L, De Zorzi SZ, Saita A, Hurle R, Lazzeri M, Guazzoni GF, Casale P, Buffi NM, Lughezzani G. Diagnostic performance of Micro-Ultrasound at MRI-guided confirmatory biopsy in patients under active surveillance for low-risk prostate cancer. Prostate 2023; 83:886-895. [PMID: 36960788 DOI: 10.1002/pros.24532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/22/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Active surveillance (AS) represents a standard of care of low-risk prostate cancer (PCa). However, identification and monitoring of AS candidates remains challenging. Micro-ultrasound (microUS) is a novel high-resolution imaging modality for transrectal ultrasonography (TRUS). We explored the impact of microUS TRUS and targeted biopsies in mpMRI-guided confirmatory biopsies. METHODS Between October 2017 and September 2021 we prospectively enrolled 100 patients scheduled for MRI-guided confirmatory biopsy at 1 year from diagnosis of ISUP 1 PCa. TRUS was performed using the ExactVu microUS system; PRI-MUS protocol was applied to identify suspicious lesions (i.e. PRIMUS score ≥3). All patients received targeted biopsies of any identified microUS and mpMRI lesions and complementary systematic biopsies. The proportion of patients upgraded to clinically significant PCa (defined as ISUP≥2 cancer; csPCa) at confirmatory biopsies was determined, and the diagnostic performance of microUS and mpMRI were compared. RESULTS 92 patients had a suspicious MRI lesion classified PI-RADS 3, 4 and 5 in respectively 28, 16 and 18 patients. MicroUS identified 82 patients with suspicious lesions, classified as PRI-MUS 3, 4 and 5 in respectively 20, 50 and 12 patients, while 18 individuals had no lesions. 34 patients were upgraded to ISUP≥2 cancer and excluded from AS. MicroUS and mpMRI showed a sensitivity of 94.1% and 100% and a NPV of 88.9% and 100% respectively in detecting ISUP≥2 patients. A microUS-mandated protocol would have avoided confirmatory biopsies in 18 patients with no PRI-MUS ≥3 lesions at the cost of missing 4 upgraded patients. CONCLUSIONS MicroUS and mpMRI represent valuable imaging modalities showing high sensitivity and NPV in detecting csPCa, thus allowing their use for event-triggered confirmatory biopsies in AS patients. MicroUS offers an alternative imaging modality to mpMRI for the identification and real-time targeting of suspicious lesions in AS patients. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Davide Maffei
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Vittorio Fasulo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Pier Paolo Avolio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Cesare Saitta
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Marco Paciotti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Fabio De Carne
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Piergiuseppe Colombo
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Department of Pathology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Luisa Pasini
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | | | - Alberto Saita
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Rodolfo Hurle
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Massimo Lazzeri
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Giorgio Ferruccio Guazzoni
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Paolo Casale
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Nicolò Maria Buffi
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
| | - Giovanni Lughezzani
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090, Milan, Italy
- IRCCS Humanitas Research Hospital, Department of Urology, via Manzoni 56, 20089, Rozzano, Mi, Italy
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Arena P, Fasulo V, Chiarelli G, Frego N, De Carne F, Maffei D, Jandric J, Gelardi F, Garofano G, Saitta C, Mancon S, Sordelli F, Beatrici E, Hurle R, Saita A, Lazzeri M, Guazzoni G, Buffi N, Lughezzani G, Casale P. Prospective evaluation of the diagnostic accuracy of different PSMA PET/CT tracers for the nodal staging of radical prostatectomy candidates: A single institutional analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00154-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Wang L, Vaida F, Meagher M, Puri D, Liu F, Dhanji S, Afari J, Hakimi K, Nguyen M, Saitta C, Shah A, Ghassemzadeh S, Nasseri R, Javier-Desloges J, Murphy J, Mckay R, Derweesh I. Proposal for reclassification of T1 and T2A renal cell carcinoma: Analysis of the National Cancer Database. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01308-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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12
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Avolio P, Fasulo V, Maffei D, Saitta C, Frego N, Paciotti M, Contieri R, De Carne F, Lazzeri M, Saita A, Hurle R, Casale P, Buffi N, Lughezzani G. Clinical and high-resolution micro-ultrasound risk factors for detecting clinically significant prostate cancer in men with PI-RADS 3 lesions: Update from a large single center experience. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00115-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Chiarelli G, Fasulo V, Zuradelli M, Arena P, Beatrici E, Gobbo A, Saitta C, Hurle R, Saita A, Maura F, Asselta R, Soldà G, Casale P, Guazzoni G, Lughezzani G, Buffi N, Lazzeri M. A dedicated screening for early detection of prostate cancer in men with germline mutations in DNA-repair genes. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00941-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Puri D, Wang L, Meagher M, Shah A, Ghassemzadeh S, Liu F, Nguyen M, Hakimi K, Saitta C, Nasseri R, Saidian A, Javier-Desloges J, Derweesh I. Outcomes of lymph node dissection in upper tract urothelial cell carcinoma in clinical N0 disease: Analysis of the national cancer database. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00962-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Meagher M, Cerrato C, Patel D, Liu F, Shah A, Ghassemzadeh S, Dhanji S, Saitta C, Wang L, Patil D, Saito K, Yasuda Y, Nasseri R, Fujii Y, Master V, Derweesh I. Should adjuvant therapy be considered for positive surgical margins in renal cell carcinoma: A stage-based analysis of impact of positive surgical margins on survival outcomes using the INMARC registry. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00509-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Fasulo V, Arena P, Chiarelli G, De Carne F, Garofano G, Maffei D, Gelardi F, Jandric J, Sordelli F, Frego N, Mancon S, Avolio P, Saitta C, Saita A, Hurle R, Casale P, Lazzeri M, Buffi N, Lughezzani G. Comparison of the diagnostic accuracy of PSMA PET/CT scan and Briganti nomogram to predict lymph node invasion in candidates to robot-assisted radical prostatectomy: A single institutional analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01266-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Garofano G, Diana P, Saitta C, Uleri A, Lughezzani G, Beatrici E, Chiarelli G, Frego N, Contieri R, Paciotti M, Fasulo V, Lazzeri M, Saita A, Hurle R, Casale P, Guazzoni G, Buffi N. The role of Mayo Adhesive Probability score in operative outcomes: A single center prospective analysis. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02548-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Diana P, Garofano G, Uleri A, Lughezzani G, Beatrici E, Saitta C, Chiarelli G, Frego N, Paciotti M, Fasulo V, Lazzeri M, Saita A, Hurle R, Casale P, Guazzoni G, Buffi N. Adherent perinephric fat as predictor of post-operative functional recovery after robot-assisted partial nephrectomy. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02561-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Saitta C, Diana P, Lughezzani G, Casale P, Uleri A, Beatrici E, Chiarelli G, Garofano G, Fasulo V, Avolio P, Lazzeri M, Hurle R, Saita A, Giorgio G, Buffi N. Renal cell carcinoma with venous thrombus: A retrospective single center surgical and oncological analysis. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02550-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Avolio P, Fasuolo V, Paciotti M, Diana P, Frego N, Maffei D, Contieri R, Uleri A, Saitta C, Beatrici E, Chiarelli G, De Carne F, Hurle R, Lazzeri M, Saita A, Casale P, Buffi N, Lughezzani G. Assessing the role of high-resolution micro-ultrasound among patients with a negative multiparametric MRI and persistent suspicion of prostate cancer. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01288-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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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, Lughezzani G, Buffi N, Casale P, 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 SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01022-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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22
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Garofano G, Diana P, Uleri A, Lughezzani G, Beatrici E, Saitta C, Frego N, Paciotti M, Contieri R, Lazzeri M, Saita A, Hurle R, Guazzoni G, Buffi N. The relationship between adherent perinephric fat and the mayo adhesive probability (MAP) score and post-operative functional outcomes in patients subjected to robot-assisted partial nephrectomy. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01188-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Maffei D, Saitta C, Avolio P, Fasulo V, Paciotti M, Frego N, Diana P, Lazzeri M, Hurle R, Saita A, Guazzoni G, Casale P, Buffi N, Lughezzani G. Diagnostic performance of micro-ultrasound guided reclassification biopsies in patients under active surveillance for prostate cancer. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01139-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Gobbo A, Negri L, Casale P, Fasulo V, Lughezzani G, Saitta C, Benaglia R, Buffi NM, Levi Setti P. Is testis sparing surgery safe in patients with incidental small testicular lesions referring to a fertility center? A retrospective analysis reporting factors correlated to malignancy and long-term oncological outcomes. Urol Oncol 2022; 40:457.e9-457.e16. [PMID: 36075820 DOI: 10.1016/j.urolonc.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/28/2022] [Accepted: 08/06/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE To define predictors of malignancy after Testis sparing surgery (TSS) in patients referring to a fertility center with incidental small testicular lesions. Sub analyses were performed to assess predictors of Leydig cell hyperplasia and Leydig cell tumor. MATERIALS AND METHODS We performed a retrospective analysis of a single institutional database including patients treated with TSS between 2002 and 2020. All patients who underwent TSS as a first line surgical approach for incidentally detected lesions found during fertility evaluation were included. RESULTS Data of 64 patients were collected. The median follow up was 58 months and no recurrences were observed. At univariable logistic regression multifocal lesions, hypervascularization, microlithiasis, age and lesion size were significantly associated with malignancy. At multivariable logistic regression lesion dimension, hypervascularization and multifocal lesions were predictors of malignancy. Lesions smaller than 5 mm proved to be benign in 96.6% of the cases (32/33). Intraoperative color of the lesion and US pattern of vascularization were predictors at multivariable logistic regression for Leydig cell hyperplasia and Leydig cell tumor. CONCLUSION Ultrasonographic characteristics and intraoperative appearance of the lesion can predict the malignant nature of small testicular lesions, guiding their surgical management in patients referring to a fertility center. Based on our experience, clinicians may safely perform TSS in carefully selected patients.
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Affiliation(s)
- Andrea Gobbo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
| | - Luciano Negri
- Department of Gynecology, Division of Gynecology and Reproductive Medicine-Fertility Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Paolo Casale
- Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Vittorio Fasulo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giovanni Lughezzani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Cesare Saitta
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Renzo Benaglia
- Department of Gynecology, Division of Gynecology and Reproductive Medicine-Fertility Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Nicolò Maria Buffi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Urology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Paolo Levi Setti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Gynecology, Division of Gynecology and Reproductive Medicine-Fertility Center, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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Beatrici E, Uleri A, Diana P, Saitta C, Chiarelli G, Arena P, Gobbo A, Fasulo V, Avolio P, D’Antuono F, Poretti D, Pedicini V, Lazzeri M, Saita A, Hurle R, Lughezzani G, Guazzoni G, Buffi N. Percutaneous microwave ablation may represent an effective treatment in selected patients with clinical T1 renal masses: a single-institutional experience. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Lazzeri M, Fasulo V, Lughezzani G, Benetti A, Soldà G, Asselta R, De Simone I, Paciotti M, Avolio PP, Contieri R, Saitta C, Saita A, Hurle R, Guazzoni G, Buffi NM, Casale P. Prospective evaluation of the role of imaging techniques and TMPRSS2:ERG mutation for the diagnosis of clinically significant prostate cancer. Front Oncol 2022; 12:968384. [PMID: 36147926 PMCID: PMC9487838 DOI: 10.3389/fonc.2022.968384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives To test the hypothesis of a relationship between a specific genetic lesion (T2:ERG) and imaging scores, such as PI-RADS and PRI-MUS, and to test the effectiveness of these parameters for the diagnosis of prostate cancer (PCa) and clinically significant PCa (csPCa). Materials and methods This is a prospective study of men with suspected PCa enrolled between 2016 and 2019 at a high-volume tertiary hospital. Patients underwent systematic US-guided biopsy, plus targeted biopsy if they were presenting with >=1 suspicious lesion (PI-RADS>2) at mpMRI or PR-IMUS >2 at micro-ultrasound assessment. For each patient, one core from the highest PI-RADS or PRI-MUS lesion was collected for T2:ERG analysis. Multivariable logistic regression models (LRMs) were fitted for csPCa with a clinical model (age, total PSA, previous biopsy, family history for PCa), a clinical plus PI-RADS, clinical plus T2:ERG, clinical plus PI-RADS plus T2:ERG, and T2:ERG plus PI-RADS alone. Results The cohort consists of 158 patients: 83.5% and 66.2% had respectively a diagnosis of PCa and csPCa after biopsy. A T2:ERG fusion was found in 37 men and 97.3% of these patients harbored PCa, while 81.1% were diagnosed with csPCa. SE of T2:ERG assay for csPCa was 28.8%, SP 87.0%, NPV 38.8%, and PPV 81.1%. Of 105 patients who performed mpMRI 93.% had PIRADS ≥3. SE of mpMRI for csPCa was 98.5%, SP was 12.8%, NPV was 83.3%, and PPV was 65.7%. Among 67 patients who were subjected to micro-US, 90% had a PRI-MUS ≥3. SE of micro-US for csPCa was 89.1%, SP was 9.52%, NPV was 28.6%, and PPV was 68.3%. At univariable LRM T2:ERG was confirmed as independent of mpMRI and micro-US result (OR 1.49, p=0.133 and OR 1.82, p=0.592, respectively). At multivariable LRM the clinical model alone had an AUC for csPCa of 0.74 while the clinical model including PI-RADS and T2:ERG achieved an AUC of 0.83. Conclusions T2:ERG translocation and imaging results are independent of each other, but both are related csPCa. To evaluate the best diagnostic work-up for PCa and csPCa detection, all available tools (T2:ERG detection and imaging techniques) should be employed together as they appear to have a complementary role.
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Affiliation(s)
- Massimo Lazzeri
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Vittorio Fasulo
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giovanni Lughezzani
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- *Correspondence: Giovanni Lughezzani,
| | - Alessio Benetti
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Giulia Soldà
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Rosanna Asselta
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Ilaria De Simone
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Marco Paciotti
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Pier Paolo Avolio
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Roberto Contieri
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Cesare Saitta
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Alberto Saita
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Rodolfo Hurle
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
| | - Giorgio Guazzoni
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Nicolò Maria Buffi
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Paolo Casale
- Department of Urology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, Milan, Italy
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Lazzeri M, Chiarelli G, Corbetta M, Asselta R, De Simone I, Soldà G, Duga S, Zuradelli M, Casale P, Saita A, Lughezzani G, Guazzoni G, Hurle R, Benetti A, Saitta C, Fasulo V, Buffi N. Post-biopsy cell-free DNA from blood in primary prostate cancer: How to get genetics data for decision making. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00573-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Maffei D, Avolio P, Saitta C, Paciotti M, Fasulo V, Beatrici E, Giuseppe C, Lazzeri M, Saita A, Hurle R, Guazzoni G, Casale P, Buffi N, Lughezzani G. Diagnostic performance of micro-ultrasound guided reclassification biopsies in patients under active surveillance for prostate cancer. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00829-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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31
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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GEMBILLO G, Cernaro V, Siligato R, Salvo A, Torre F, Saitta C, Santoro D. POS-426 IgAN in a patient with Wilson's Disease: a very rare association. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Lazzara C, Navarra G, Lazzara S, Barbera A, Saitta C, Raimondo G, Latteri S, Currò G. Does the margin width influence recurrence rate in liver surgery for hepatocellular carcinoma smaller than 5 cm? Eur Rev Med Pharmacol Sci 2017; 21:523-529. [PMID: 28239817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Liver surgery is considered a curative treatment for hepatocellular carcinoma (HCC) but the importance of resection margin width remains controversial. The aim of this study is to clarify the role of 5-10 mm surgical margin width on post-operative recurrence and overall survival after resection. PATIENTS AND METHODS We analyzed recurrence rate and overall survival rate of 72 patients who underwent curative hepatic resection for HCC smaller than 5 cm with 5-10 mm surgical margin width between January 2005 and December 2014. RESULTS The mean follow-up period was 36 months. Among the seventy-two patients, thirty-one (31/72; 43%) developed recurrence but only eleven (11/31; 15.3%) along the resection margin. The disease-free survival was 77.2%, 50%, 41.4% at 1, 3 and 5 years respectively, and the overall survival was 89.9%, 78.8%, 60% at 1, 3 and 5 years respectively. CONCLUSIONS 5-10 mm surgical resection margin for HCC smaller than 5 cm seems to be safe as a wider surgical margin because does not increase the risk of marginal recurrence and does not decrease overall survival rate. Further prospective and randomized studies are required to definitively clarify the importance of surgical margin width in hepatic resection for HCC.
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Affiliation(s)
- C Lazzara
- Department of Human Pathology of Adult and Evolutive Age, University Hospital of Messina, Messina, Italy.
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Zolfino T, Lorusso V, D'Angelo S, Sansonno D, Giannitrapani L, Benedetti A, Montesarchio V, Attili A, Buonadonna A, Barni S, Gasbarrini A, Pirisi M, Cillo U, Picciotto A, Villa E, Giovanis P, Pinotti G, Saitta C, Erminero C, de Giorgio M, Daniele B. Hepatocellular Carcinoma In Elderly Patients: final results of The Italian Cohort Of GIDEON (Global Investigational of therapeutic DEcisions in HCC and of its treatment with sorafeNib) Study. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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D'Angelo S, Germano D, Zolfino T, Sansonno D, Montalto G, Benedetti A, Montesarchio V, Attili A, Buonadonna A, Barni S, Gasbarrini A, Pirisi M, Cillo U, Marenco S, Villa E, Giovanis P, Pinotti G, Saitta C, Erminero C, de Giorgio M, Lorusso V. Final results of the gideon study according to patient etiology: The italian experience. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv344.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lo Gullo A, Mandraffino G, Sardo MA, D'Ascola A, Mamone F, Loddo S, Alibrandi A, Imbalzano E, Mandraffino R, Mormina E, Saitta C, Lo Gullo R, David A, Saitta A. Circulating progenitor cells in rheumatoid arthritis: association with inflammation and oxidative stress. Scand J Rheumatol 2013; 43:184-93. [PMID: 24313545 DOI: 10.3109/03009742.2013.836564] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate the association between inflammation, oxidative stress, and circulating progenitor cell (CPC) number and redox equilibrium, vascular lesions and accelerated atherosclerosis in rheumatoid arthritis (RA). METHOD Circulating CD34+ cells were isolated from 33 RA patients and 33 controls. Reactive oxygen species (ROS) levels and mRNA expression of manganese superoxide dismutase (MnSOD), catalase (CAT), glutathione peroxidase type 1 (GPx-1) antioxidant enzymes, and the gp91phox-containing nicotinamide adenine dinucleotide phosphate (NADPH) oxidase NOX2 were measured in CD34+ cells. C-reactive protein (CRP), fibrinogen, erythrocyte sedimentation rate (ESR), carotid intima-media thickness (cIMT), and arterial stiffness (AS) were also evaluated. We investigated the relationships between inflammatory markers, vascular parameters, cell number, and antioxidant enzymes. RESULTS CD34+ cell number was lower in RA patients than in controls. In CD34+ cells from RA patients, ROS levels, MnSOD mRNA, and NOX2 mRNA were higher, while mRNA expression of GPx-1 and CAT was significantly lower. The AS, pulse wave velocity (PWV), and augmentation index (AIx) were higher, as was cIMT. CD34+ cell number was inversely correlated with CRP, ROS, PWV, and AIx, and with the CAT/MnSOD and GPx-1/MnSOD ratios. CRP was correlated with MnSOD mRNA, PWV, and AIx but not with CAT and GPx-1 mRNA. CONCLUSIONS Our data show a link between inflammation, oxidative stress, and the impairment of the antioxidant system of CPCs and their number, and with arterial stiffness in RA subjects. This could suggest a perspective on the accelerated development of vascular damage and atherosclerosis in RA.
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Affiliation(s)
- A Lo Gullo
- Departments of Internal Medicine and Medical Therapy, University of Messina , Italy
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Lo Gullo A, Mandraffino G, Sardo A, D’Ascola A, Imbalzano E, Saitta C, Cinquegrani M, Lo Gullo R, Bagnato G, Bagnato G, Saitta A. AB0147 Oxidative stress and flogosis: The role of endothelial progenitor cells in rheumathoid arthtritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lo Gullo A, Mandraffino G, Sardo MA, Imbalzano E, Visalli E, Mamone F, Mandraffino R, Saitta C, Atteritano M, Lo Gullo R, Bagnato G, Saitta A. FRI0103 Vit d deficiency, depletion of circulating endothelial progenitor cells and impaired arterial stiffness in patients with ra. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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40
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Lo Gullo A, Mandraffino G, Sardo MA, Mamone F, Mandraffino R, Saitta C, Lo Gullo R, Versace AG, Cinquegrani M, Saitta A. AB0075 Toll-like receptor 3 and interleukine 1b expression in circulating progenitor cells isolated from patients with rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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41
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Riggio S, Mandraffino G, Sardo MA, Iudicello R, Camarda N, Imbalzano E, Alibrandi A, Saitta C, Carerj S, Arrigo T, Saitta A. Pulse wave velocity and augmentation index, but not intima-media thickness, are early indicators of vascular damage in hypercholesterolemic children. Eur J Clin Invest 2010; 40:250-7. [PMID: 20415700 DOI: 10.1111/j.1365-2362.2010.02260.x] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Arterial stiffness is an important determinant of cardiovascular risk. It is associated with several cardiovascular risk factors, including hypertension, diabetes and cigarette smoking. However, there are conflicting data about the relationship between arterial stiffness and hypercholesterolemia. Furthermore, augmentation index (AIx), a measure of systemic arterial stiffness, has not been previously investigated in hypercholesterolemic (HCh) children. Aim of our study was to evaluate local and systemic arterial stiffness as well as carotid intima-media thickness (IMT) in HCh children and also to investigate the relation between serum cholesterol levels and arterial stiffness. MATERIALS AND METHODS We determined lipid profile, body mass index, blood pressure, heart rate, carotid IMT and several arterial stiffness parameters, as beta-index, elastic modulus (E(p)), arterial compliance (AC), pulse wave velocity (PWV) and AIx, in 44 untreated HCh children (mean age 10.7 +/- 2.8 years; 18 with familial hypercholesterolemia, FH, and 26 with primary hypercholesterolemia, PHC) and 18 age- and sex-matched controls. HCh children never received any medication, including antihypertensive and lipid lowering drugs. RESULTS Respect to controls and to PHC, FH had significantly higher (P < 0.001) beta-index (5.22 +/- 1.13 vs. 3.13 +/- 0.74 and 3.60 +/- 1.02), PWV (4.72 +/- 0.72 m s(-1) vs. 3.66 +/- 0.55 m s(-1) and 4.10 +/- 0.67 m s(-1)), AIx (3.55 +/- 3.97% vs. -4.43 +/- 4.09% and 0.61 +/- 2.39%) and E(p) (64.4 +/- 19.6 kPa vs. 36.2 +/- 11.3 kPa and 42.9 +/- 13.1), whereas AC (1.25 +/- 0.48 mm(2) kPa(-1) vs. 1.9 +/- 0.43 mm(2) kPa(-1) and 1.62 +/- 0.43 mm(2) kPa(-1)) was lower (P < 0.001). There was no significant difference in carotid IMT and blood pressure values between the groups. The multiple regression analysis showed a significant association of arterial stiffness values with plasma cholesterol levels (P < 0.0001). CONCLUSION Our findings show that local and systemic arterial stiffness are increased in asymptomatic, normotensive HCh children, suggesting that HCh plays a key role in arterial mechanical impairment since the paediatric age.
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Affiliation(s)
- S Riggio
- Department of Internal Medicine and Medical Therapy, University of Messina, 8298123 Messina, Italy
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Bonaiuto A, Bitto A, Sardo M, Polito F, Saitta C, Squadrito F, Saitta A. Mo-P6:458 A 1-year study on hydroxy-methylglutaryl coenzymea reductase gene expression and polymorphisms in hypercholesterolemic treated with statins. ATHEROSCLEROSIS SUPP 2006. [DOI: 10.1016/s1567-5688(06)80588-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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