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Cerrato C, Crocerossa F, Marchioni M, Giannarini G, Gupta S, Albiges L, Brouwer O, Albersen M, Fankhauser C, Grimm MO, Gandaglia G, Roupret M, Mir MC. Effect of Sex on the Oncological Outcomes in Response to Immunotherapy and Antibody-drug Conjugates in Patients with Urothelial and Kidney Cancer: A Systematic Review and a Network Meta-analysis. Eur Urol Oncol 2024:S2588-9311(24)00096-8. [PMID: 38644155 DOI: 10.1016/j.euo.2024.03.014] [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: 01/28/2024] [Revised: 03/03/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND AND OBJECTIVE Immune checkpoint inhibitors (ICIs) and antibody-drug conjugates (ADCs) herald a transformative era in metastatic renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) treatment, amid acknowledged sex-based disparities in these cancers. We conducted a systematic review and network meta-analysis (NMA) to identify sex-specific differences in the efficacy of ICI/ADC monotherapy or combination therapies for RCC and TCC survival, in metastatic and adjuvant settings. METHODS A systematic search was conducted up to October 2023 for English articles on ICIs and ADCs as systemic therapies (ICIs in first-line and adjuvant treatment for RCC, ICIs and ADCs in first- and second-line treatment for TCC). Randomised clinical trials were considered. The primary objective was overall survival (OS) of ICIs and ADCs between males and females. The secondary outcomes included progression-free survival, overall response rate, disease-free survival, and recurrence-free survival. Treatment efficacy was evaluated by sex via odds ratios (ORs) and confidence intervals compared with controls. Log ORs were used for creating a frequentist NMA. This meta-analysis was registered on PROSPERO (CRD42023468632). KEY FINDINGS AND LIMITATIONS Eighteen articles met the inclusion criteria. Females had an advantage for RCC-adjuvant treatment for atezolizumab (log OR [SE] = -0.57 ± 0.25, p = 0.024) in OS. Males showed a survival advantage in TCC second-line treatment for ADC-Nectin 4 (log OR [SE] = 0.65 ± 0.28, p = 0.02). No other significant results were shown. CONCLUSIONS AND CLINICAL IMPLICATIONS The NMA revealed gender-specific variations in ICI and ADC responses for RCC and TCC, offering insights for personalised cancer care and addressing disparities in cancer care and outcomes. PATIENT SUMMARY In this systematic review, we looked at the sex differences for metastatic renal cell carcinoma (RCC) and transitional cell carcinoma (TCC) for antibody-drug conjugates and immune checkpoint inhibitors. In our analysis, female and male sex has better overall survival for adjuvant and second-line therapies for RCC and TCC, respectively. Urgent research on gender-specific cancer therapies is imperative.
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Affiliation(s)
- Clara Cerrato
- University Hospital Southampton NHS Trust, Southampton, UK
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Gianluca Giannarini
- Urology Unit, "Santa Maria della Misericordia" University Hospital, Udine, Italy
| | - Shilpa Gupta
- Cleveland Clinic Taussig Cancer Institute, Cleveland, OH, USA
| | - Laurence Albiges
- Department of Cancer Medicine, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Oscar Brouwer
- The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Christian Fankhauser
- Department of Urology, Luzerner Kantonsspital, Luzern, Switzerland; University of Lucerne, Lucerne, Switzerland; University of Zurich, Zurich, Switzerland
| | | | - Giorgio Gandaglia
- Department of Urology, Division of Experimental Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Morgan Roupret
- GRC 5 Predictive Onco-Uro, Department of Urology, AP-HP, Pitié Salpétrière Hospital, Sorbonne University, Paris, France
| | - Maria Carmen Mir
- Department of Urology, Hospital Universitario La Ribera, Valencia, Spain.
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Aveta A, Iossa V, Spena G, Conforti P, Pagano G, Dinacci F, Verze P, Manfredi C, Ferro M, Lasorsa F, Spirito L, Napolitano L, Tufano A, Fiorenza A, Russo P, Crocerossa F, Lucarelli G, Perdonà S, Sanseverino R, Siracusano S, Cilio S, Pandolfo SD. Ablative Treatments for Small Renal Masses and Management of Recurrences: A Comprehensive Review. Life (Basel) 2024; 14:450. [PMID: 38672721 PMCID: PMC11050889 DOI: 10.3390/life14040450] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 03/04/2024] [Revised: 03/23/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
This review focuses on ablative techniques for small renal masses (SRMs), including radiofrequency ablation (RFA), cryoablation (CA), microwave ablation (MWA), and irreversible electroporation (IRE), and discusses recurrence management. Through an extensive literature review, we outline the procedures, outcomes, and follow-up strategies associated with each ablative method. The review provides a detailed examination of these techniques-RFA, CA, MWA, and IRE-elucidating their respective outcomes. Recurrence rates vary among them, with RFA and CA showing comparable rates, MWA demonstrating favorable short-term results, and IRE exhibiting promise in experimental stages. For managing recurrences, various strategies are considered, including active surveillance, re-ablation, or salvage surgery. Surveillance is preferred post-RFA and post-CA, due to slow SRM growth, while re-ablation, particularly with RFA and CA, is deemed feasible without additional complications. Salvage surgery emerges as a viable option for larger or resistant tumors. While ablative techniques offer short-term results comparable to surgery, further research is essential to understand their long-term effects fully. Decisions concerning recurrence management should consider individual and tumor-specific factors. Imaging, notably contrast-enhanced ultrasounds, plays a pivotal role in assessing treatment success, emphasizing the necessity of a multidisciplinary approach for optimal outcomes. The lack of randomized trials highlights the need for further research.
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Affiliation(s)
- Achille Aveta
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (A.A.); (P.C.); (G.P.); (F.D.); (L.N.); (A.F.); (S.C.)
- Department of Urology, Umberto I Hospital, ASL Salerno, 84014 Nocera Inferiore, Italy; (V.I.); (R.S.)
| | - Vincenzo Iossa
- Department of Urology, Umberto I Hospital, ASL Salerno, 84014 Nocera Inferiore, Italy; (V.I.); (R.S.)
- Department of Urology, University of L’Aquila, 67100 L’Aquila, Italy;
| | - Gianluca Spena
- Department of Urology, Istituto Nazionale Tumori, IRCCS, “Fondazione G. Pascale”, 80131 Naples, Italy; (G.S.); (A.T.); (S.P.)
| | - Paolo Conforti
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (A.A.); (P.C.); (G.P.); (F.D.); (L.N.); (A.F.); (S.C.)
| | - Giovanni Pagano
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (A.A.); (P.C.); (G.P.); (F.D.); (L.N.); (A.F.); (S.C.)
| | - Fabrizio Dinacci
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (A.A.); (P.C.); (G.P.); (F.D.); (L.N.); (A.F.); (S.C.)
| | - Paolo Verze
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, 84081 Fisciano, Italy;
| | - Celeste Manfredi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (C.M.); (L.S.)
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology, IRCCS, 71013 Milan, Italy;
| | - Francesco Lasorsa
- Department of Precision and Regenerative Medicine and Ionian Area-Urology, Andrology and Kidney Transplantation Unit, University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.L.); (G.L.)
| | - Lorenzo Spirito
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy; (C.M.); (L.S.)
| | - Luigi Napolitano
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (A.A.); (P.C.); (G.P.); (F.D.); (L.N.); (A.F.); (S.C.)
| | - Antonio Tufano
- Department of Urology, Istituto Nazionale Tumori, IRCCS, “Fondazione G. Pascale”, 80131 Naples, Italy; (G.S.); (A.T.); (S.P.)
| | - Alessandra Fiorenza
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (A.A.); (P.C.); (G.P.); (F.D.); (L.N.); (A.F.); (S.C.)
| | - Pierluigi Russo
- Department of Urology, Fondazione Policlinico Universitario Agostino Gemelli, Largo Francesco Vito 1, 00168 Rome, Italy;
| | - Fabio Crocerossa
- Division of Urology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy;
| | - Giuseppe Lucarelli
- Department of Precision and Regenerative Medicine and Ionian Area-Urology, Andrology and Kidney Transplantation Unit, University of Bari “Aldo Moro”, 70124 Bari, Italy; (F.L.); (G.L.)
| | - Sisto Perdonà
- Department of Urology, Istituto Nazionale Tumori, IRCCS, “Fondazione G. Pascale”, 80131 Naples, Italy; (G.S.); (A.T.); (S.P.)
| | - Roberto Sanseverino
- Department of Urology, Umberto I Hospital, ASL Salerno, 84014 Nocera Inferiore, Italy; (V.I.); (R.S.)
| | | | - Simone Cilio
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (A.A.); (P.C.); (G.P.); (F.D.); (L.N.); (A.F.); (S.C.)
| | - Savio Domenico Pandolfo
- Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy; (A.A.); (P.C.); (G.P.); (F.D.); (L.N.); (A.F.); (S.C.)
- Department of Urology, University of L’Aquila, 67100 L’Aquila, Italy;
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, 84081 Fisciano, Italy;
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Mondaini N, Gacci M, Cai T, Lotti F, Li Marzi V, Crocerossa F, Abramo A, Cantiello F, Fusco I, Comito A, Tanguenza S, Damiano R. Efficacy of top flat magnetic stimulation for chronic pelvic pain in men: preliminary results. Int J Impot Res 2024:10.1038/s41443-023-00822-1. [PMID: 38238482 DOI: 10.1038/s41443-023-00822-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/30/2023] [Accepted: 12/22/2023] [Indexed: 03/22/2024]
Affiliation(s)
- Nicola Mondaini
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Mauro Gacci
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Tommaso Cai
- Department of Urology, Santa Chiara Regional Hospital, Trento, Italy
| | - Francesco Lotti
- Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Vincenzo Li Marzi
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, University of Florence, Florence, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Andrea Abramo
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | | | | | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Marchioni M, Primiceri G, Veccia A, Di Nicola M, Carbonara U, Crocerossa F, Falagario U, Rizzoli A, Autorino R, Schips L. Transurethral prostate surgery in prostate cancer patients: A population-based comparative analysis of complication and mortality rates. Asian J Urol 2024; 11:48-54. [PMID: 38312810 PMCID: PMC10837658 DOI: 10.1016/j.ajur.2022.05.008] [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: 09/29/2021] [Accepted: 05/09/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Prostate cancer (PCa) patients might experience lower urinary tract symptoms as those diagnosed with benign prostatic hyperplasia (BPH). Some of them might be treated for their lower urinary tract symptoms instead of PCa. We aimed to test the effect of PCa versus BPH on surgical outcomes after transurethral prostate surgery, namely complication and mortality rates. Methods Within the American College of Surgeons National Surgical Quality Improvement Program database (2011-2016), we identified patients who underwent transurethral resection of the prostate, photoselective vaporization, or laser enucleation. Patients were stratified according to postoperative diagnosis (PCa vs. BPH). Univariable and multivariable logistic regression models evaluated the predictors of perioperative morbidity and mortality. A formal test of interaction between diagnosis and surgical technique used was performed. Results Overall, 34 542 patients were included. Of all, 2008 (5.8%) had a diagnosis of PCa. The multivariable logistic regression model failed to show statistically significant higher rates of postoperative complications in PCa patients (odds ratio: 0.9, 95% confidence interval: 0.7-1.1; p=0.252). Moreover, similar rates of perioperative mortality (p=0.255), major acute cardiovascular events (p=0.581), transfusions (p=0.933), and length of stay of more than or equal to 30 days (p=0.174) were found. Additionally, all tests failed to show an interaction between post-operative diagnosis and surgical technique used. Conclusion Patients diagnosed with PCa do not experience higher perioperative morbidity or mortality after transurethral prostate surgery when compared to their BPH counterparts. Moreover, the diagnosis seems to not influence surgical technique outcomes.
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Affiliation(s)
- Michele Marchioni
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, “G. d'Annunzio” University of Chieti, Chieti, Italy
- Urology Unit, Department of Medical, Oral and Biotechnological Sciences, “G. d'Annunzio” University of Chieti, Chieti, Italy
| | - Giulia Primiceri
- Urology Unit, Department of Medical, Oral and Biotechnological Sciences, “G. d'Annunzio” University of Chieti, Chieti, Italy
| | | | - Marta Di Nicola
- Laboratory of Biostatistics, Department of Medical, Oral and Biotechnological Sciences, “G. d'Annunzio” University of Chieti, Chieti, Italy
| | | | | | | | - Ambra Rizzoli
- Urology Unit, Department of Medical, Oral and Biotechnological Sciences, “G. d'Annunzio” University of Chieti, Chieti, Italy
| | | | - Luigi Schips
- Urology Unit, Department of Medical, Oral and Biotechnological Sciences, “G. d'Annunzio” University of Chieti, Chieti, Italy
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Ditonno F, Franco A, Manfredi C, Fasanella D, Abate M, La Rocca R, Crocerossa F, Iossa V, Falagario UG, Cirillo L, Altieri VM, Di Mauro E, Crocetto F, Barone B, Cilio S, Pandolfo SD, Aveta A, Mirone V, Franzese CA, Arcaniolo D, Napolitano L. The Role of miRNA in Testicular Cancer: Current Insights and Future Perspectives. Medicina (Kaunas) 2023; 59:2033. [PMID: 38004082 PMCID: PMC10672751 DOI: 10.3390/medicina59112033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 11/09/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Despite advancements in the diagnosis and treatment of testicular germ cell tumours (TGTCs), challenges persist in identifying reliable biomarkers for early detection and precise disease management. This narrative review addresses the role of microRNAs (miRNAs) as potential diagnostic tools and therapeutic targets in the treatment of TGCTs. Materials and Methods: Three databases (PubMed®, Web of Science™, and Scopus®) were queried for studies investigating the utility of miRNA as diagnostic tools, assessing their prognostic significance, and evaluating their potential to guide TGCT treatment. Different combinations of the following keywords were used, according to a free-text protocol: "miRNA", "non-coding RNA", "small RNA", "Testicular Cancer", "seminomatous testicular germ cell", "non-seminomatous testicular germ cell". Results: The potential of miRNAs as possible biomarkers for a non-invasive diagnosis of TGCT is appealing. Their integration into the diagnostic pathway for TGCT patients holds the potential to enhance the discriminative power of conventional serum tumour markers (STMs) and could expedite early diagnosis, given that miRNA overexpression was observed in 50% of GCNIS cases. Among miRNAs, miR-371a-3p stands out with the most promising evidence, suggesting its relevance in the primary diagnosis of TGCT, particularly when conventional STMs offer limited value. Indeed, it demonstrated high specificity (90-99%) and sensitivity (84-89%), with good positive predictive value (97.2%) and negative predictive value (82.7%). Furthermore, a direct relationship between miRNA concentration, disease burden, and treatment response exists, regardless of disease stages. The initial evidence of miRNA decrease in response to surgical treatment and systemic chemotherapy has been further supported by more recent results suggesting the potential utility of this tool not only in evaluating treatment response but also in monitoring residual disease and predicting disease relapse. Conclusions: MiRNAs could represent a reliable tool for accurate diagnosis and disease monitoring in the treatment of TGCT, providing more precise tools for early detection and treatment stratification. Nevertheless, well-designed clinical trials and comprehensive long-term data are needed to ensure their translation into effective clinical tools.
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Affiliation(s)
- Francesco Ditonno
- Department of Urology, Rush University Medical Center, Chicago, IL 60612-3833, USA
- Department of Urology, University of Verona, 37126 Verona, Italy
| | - Antonio Franco
- Department of Urology, Rush University Medical Center, Chicago, IL 60612-3833, USA
- Department of Urology, Sant'Andrea Hospital, La Sapienza University, 00189 Rome, Italy
| | - Celeste Manfredi
- Department of Urology, Rush University Medical Center, Chicago, IL 60612-3833, USA
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, "Luigi Vanvitelli" University, 81100 Naples, Italy
| | - Daniela Fasanella
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Marco Abate
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Roberto La Rocca
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
| | - Vincenzo Iossa
- Department of Andrology, "Antonio Cardarelli" Hospital, 80131 Naples, Italy
| | - Ugo Giovanni Falagario
- Department of Urology and Organ Transplantation, University of Foggia, 71122 Foggia, Italy
| | - Luigi Cirillo
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Vincenzo Maria Altieri
- Department of Medicine and Health Sciences "V. Tiberio", University of Molise, 86100 Campobasso, Italy
- Department of Urology, Humanitas Gavazzeni, 24125 Bergamo, Italy
| | - Ernesto Di Mauro
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Felice Crocetto
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Biagio Barone
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Simone Cilio
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Savio Domenico Pandolfo
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Achille Aveta
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | - Vincenzo Mirone
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
| | | | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, "Luigi Vanvitelli" University, 81100 Naples, Italy
| | - Luigi Napolitano
- Urology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", 80138 Naples, Italy
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Crocerossa F, Cantiello F, Bagalá L, Sicoli F, Carbonara U, Manfredi C, Falagario U, Veccia A, Pandolfo SD, Napolitano L, Ferro M, Di Dio M, Mondaini N, Damiano R. Clinical Effects of Oral Supplementation of Gamma-Cyclodextrin Curcumin Complex in Male Patients with Moderate-To-Severe Benign Prostatic Hyperplasia-Related Lower Urinary Tract Symptoms. Urol Int 2023; 107:924-934. [PMID: 37939691 DOI: 10.1159/000534148] [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: 04/05/2023] [Accepted: 09/02/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Benign prostatic hyperplasia (BPH) is the most common cause of lower urinary tract symptoms (LUTSs) in males. Curcumin exhibits anti-inflammatory and anti-tumor properties which may be effective for BPH. This multi-arm observational study evaluated the real-world efficacy of QURMIN® (Gamma-cyclodextrin-curcumin Complex-CAVACURMIN®) as single or combination therapy for BPH. METHODS Men with moderate-severe LUTS/BPH, receiving a 6-month supplementation with QURMIN® alone or in combination with BPH-specific medication were propensity score matched with patients not taking curcumin and then divided into subgroups based on concomitant baseline treatment. Cohorts were compared in the 6-month variation of IPSS, quality of life (IPSS-QoL), Benign Prostatic Hyperplasia Impact Index (BII) and uroflowmetry parameters. Curcumin tolerability was evaluated in terms of discontinuations and adverse effects. RESULTS The 1:1 propensity score matching resulted in a treatment-naïve (n = 152), an alpha-blocker only (AB) (n = 138) and AB + 5-alpha reductase inhibitors (5-ARIs) (n = 78) subgroup. After 6 months, drug-naïve patients taking curcumin reported significant improvement in IPSS-storage (-3.9, p < 0.001), IPSS-voiding (-2.0, p = 0.011), IPSS-total (-5.9, p < 0.001), IPSS-QoL (-3.9, p < 0.001), BII (-2.0, p < 0.001), Qmax (+3.1 mL/s, p < 0.001), Qmean (+1.9 mL/s, p = 0.005), post-void residual volume (-7.7 mL, p < 0.001), and PSA (-0.3 ng/mL, p = 0.003), compared to controls. Patients taking ABs and curcumin showed improvement in IPSS-storage (-2.7, p < 0.001), IPSS-voiding (-1.3, p = 0.033), IPSS-total (-3.5, p < 0.001), IPSS-QoL (-1.1, p = 0.004), BII (-1.7, p = 0.006), Qmax (+1.0 mL/s, p = 0.006), and PSA (-0.2 ng/mL, p = 0.01). Patients taking curcumin and AB + 5-ARI showed improvement in IPSS-storage (-1.3, p = 0.007), IPSS-total (-1.6, p = 0.034), IPSS-QoL (-1.1, p < 0.001), and BII (-2.0, p < 0.001). No adverse reactions were reported for curcumin supplementation. CONCLUSION QURMIN® (CAVACURMIN®) led to significant improvements in symptom burden, uroflow parameters, and QoL, without significant additional side effects, thus proving to be a potential new treatment for BPH, either as a single therapy or in addition to standard treatment.
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Affiliation(s)
- Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
- Department of Urology, IMED Hospitals, Valencia, Spain
| | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Lorenzo Bagalá
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Sicoli
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Celeste Manfredi
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ugo Falagario
- Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy
| | | | - Savio D Pandolfo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology IRCCS, Milan, Italy
| | - Michele Di Dio
- Division of Urology, Department of Surgery, SS Annunziata Hospital, Cosenza, Italy
| | - Nicola Mondaini
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
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7
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Pandolfo SD, Del Giudice F, Chung BI, Manfredi C, De Sio M, Damiano R, Cherullo EE, De Nunzio C, Cacciamani GE, Cindolo L, Porpiglia F, Mirone V, Imbimbo C, Autorino R, Crocerossa F. Robotic assisted simple prostatectomy versus other treatment modalities for large benign prostatic hyperplasia: a systematic review and meta-analysis of over 6500 cases. Prostate Cancer Prostatic Dis 2023; 26:495-510. [PMID: 36402815 DOI: 10.1038/s41391-022-00616-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 10/20/2022] [Accepted: 11/07/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Current guidelines recommend simple prostatectomy or endoscopic enucleation of the prostate (EEP) as treatment of choice for bladder prostatic obstruction (BPO) caused by large prostate glands. We aimed to provide a wide-ranging analysis of the currently available evidence, comparing safety and effectiveness of robot-assisted simple prostatectomy (RASP) versus open simple prostatectomy (OSP), laparoscopic simple prostatectomy (LSP), and laser EEP. METHODS A systematic search was performed across MEDLINE, EMBASE, and Web of Science databases for retrospective and prospective studies comparing RASP to OSP or LSP or laser EEP (HoLEP/ThuLEP). Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) recommendations were followed to design the search strategies, selection criteria, and evidence report. A meta-analysis evaluated perioperative safety and effectiveness outcomes. The weighted mean difference and risk ratio were used to compare continuous and dichotomous variables, respectively. Quality was assessed using the Newcastle-Ottawa scale and the Cochrane Collaboration's tool for RCT article assessing risk of bias. RESULTS 15 studies, including 6659 patients, were selected for meta-analysis: 13 observational studies, 1 non-randomized prospective study, and 1 randomized controlled trial. RASP was associated with statistically significant longer operative time (OT) and lower postoperative complication rate, length of stay (LOS), estimated blood loss (EBL), and transfusion rate (TR) compared to OSP. LSP showed longer LOS and lower postoperative SHIM score, with no difference in OT, EBL, and complications. Compared to laser EEP, RASP presented longer LOS and catheterization time and higher TR. ThuLEP presented shorter OT than RASP. No difference were found in functional outcomes between groups both subjectively (IPSS, QoL) and objectively (Qmax, PVR). CONCLUSION RASP has become a size-independent treatment for the management of BPO caused by a large prostate gland. It can duplicate the functional outcomes of OSP while offering a better safety profile. When compared to LSP, the latter still stands as a valid lower-cost option, but it requires solid laparoscopic skill sets and therefore it is unlikely to spread on larger scale. When compared to laser EEP, RASP offers a shorter learning curve, but it still suffers from longer catheterization time and LOS.
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Affiliation(s)
- Savio Domenico Pandolfo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Francesco Del Giudice
- Department of Maternal-Infant and Urologic Sciences, "Sapienza" University of Rome, Policlinico Umberto I Hospital, Rome, Italy
- Department of Urology, Stanford Medical Center, Stanford, CA, USA
| | - Benjamin I Chung
- Department of Urology, Stanford Medical Center, Stanford, CA, USA
| | - Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco De Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Rocco Damiano
- Urology Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Edward E Cherullo
- Department of Urology, Rush University Medical Center, Chicago, IL, USA
| | - Cosimo De Nunzio
- Urology Unit, Ospedale Sant'Andrea, La Sapienza University of Rome, Rome, Italy
| | - Giovanni E Cacciamani
- USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Luca Cindolo
- Department of Urology, Villa Stuart, Private Hospital, Rome, Italy
| | - Francesco Porpiglia
- Division of Urology, School of Medicine, University of Turin, San Luigi Hospital, Orbassano, Turin, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Naples, Italy
| | - Riccardo Autorino
- Department of Urology, Rush University Medical Center, Chicago, IL, USA.
| | - Fabio Crocerossa
- Urology Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
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8
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Aveta A, Cilio S, Contieri R, Spena G, Napolitano L, Manfredi C, Franco A, Crocerossa F, Cerrato C, Ferro M, Del Giudice F, Verze P, Lasorsa F, Salonia A, Nair R, Walz J, Lucarelli G, Pandolfo SD. Urinary MicroRNAs as Biomarkers of Urological Cancers: A Systematic Review. Int J Mol Sci 2023; 24:10846. [PMID: 37446024 DOI: 10.3390/ijms241310846] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [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: 05/25/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
MicroRNAs (miRNAs) are emerging as biomarkers for the detection and prognosis of cancers due to their inherent stability and resilience. To summarize the evidence regarding the role of urinary miRNAs (umiRNAs) in the detection, prognosis, and therapy of genitourinary cancers, we performed a systematic review of the most important scientific databases using the following keywords: (urinary miRNA) AND (prostate cancer); (urinary miRNA) AND (bladder cancer); (urinary miRNA) AND (renal cancer); (urinary miRNA) AND (testicular cancer); (urinary miRNA) AND (urothelial cancer). Of all, 1364 articles were screened. Only original studies in the English language on human specimens were considered for inclusion in our systematic review. Thus, a convenient sample of 60 original articles was identified. UmiRNAs are up- or downregulated in prostate cancer and may serve as potential non-invasive molecular biomarkers. Several umiRNAs have been identified as diagnostic biomarkers of urothelial carcinoma and bladder cancer (BC), allowing us to discriminate malignant from nonmalignant forms of hematuria. UmiRNAs could serve as therapeutic targets or recurrence markers of non-muscle-invasive BC and could predict the aggressivity and prognosis of muscle-invasive BC. In renal cell carcinoma, miRNAs have been identified as predictors of tumor detection, aggressiveness, and progression to metastasis. UmiRNAs could play an important role in the diagnosis, prognosis, and therapy of urological cancers.
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Affiliation(s)
- Achille Aveta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", 80138 Naples, Italy
- Department of Urology, Institut Paoli-Calmettes Cancer Centre, 13055 Marseille, France
| | - Simone Cilio
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", 80138 Naples, Italy
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Roberto Contieri
- Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, Italy
| | - Gianluca Spena
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", 80138 Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", 80138 Naples, Italy
| | - Celeste Manfredi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
| | - Antonio Franco
- Department of Urology, Sant'Andrea Hospital, "La Sapienza" University, 00189 Rome, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
| | - Clara Cerrato
- Urology Unit, University Hospital Southampton NHS Trust, Southampton SO16 6YD, UK
| | - Matteo Ferro
- Division of Urology, European Institute of Oncology, 20122 Milan, Italy
| | | | - Paolo Verze
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, 84081 Fisciano, Italy
| | - Francesco Lasorsa
- Urology, Andrology and Kidney Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
| | - Rajesh Nair
- The Urology Centre, Guy's and St. Thomas' NHS Foundation Trust, Guy's Hospital, London SE1 9RT, UK
| | - Jochen Walz
- Department of Urology, Institut Paoli-Calmettes Cancer Centre, 13055 Marseille, France
| | - Giuseppe Lucarelli
- Urology, Andrology and Kidney Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", 70124 Bari, Italy
| | - Savio Domenico Pandolfo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, Urology Unit, University of Naples "Federico II", 80138 Naples, Italy
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, 84081 Fisciano, Italy
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9
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Pandolfo SD, Crauso F, Aveta A, Cilio S, Barone B, Napolitano L, Scarpato A, Mirto BF, Serino F, Del Giudice F, Chung BI, Crocerossa F, Di Zazzo E, Trama F, Vaglio R, Wu Z, Verze P, Imbimbo C, Crocetto F. A Novel Low-Cost Uroflowmetry for Patient Telemonitoring. Int J Environ Res Public Health 2023; 20:3287. [PMID: 36833979 PMCID: PMC9960409 DOI: 10.3390/ijerph20043287] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/12/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
Uroflowmetry (UF) is a crucial guideline-recommended tool for men with benign prostatic obstruction (BPO). Moreover, UF is a helpful decision-making tool for the management of patients with lower urinary tract symptoms (LUTS) and benign prostatic hyperplasia (BPH). In the last few years, telemedicine and telehealth have increased exponentially as cost-effective treatment options for both patients and physicians. Telemedicine and telehealth have been well positioned during the COVID-19 pandemic to prevent healthcare system overload and to ensure adequate management of patients through screening, diagnosis, and follow-up at home. In the present manuscript, the main characteristics and performance of a novel and low-cost device for home-based UF have been analyzed. The simple weight-transducer method has been applied to perform UF. An inexpensive load cell connected to a 24 bit analogic digital converter (ADC) sends data to a cloud server via SIM card or home Wi-Fi. Data are processed and shown in graphics with both volume and flow rate as a function of time, allowing for measurement of average flow rate, maximum flow rate, voided volume, and voiding time. A numerical algorithm allows for filtering of the dynamic effect due to the urine gravity acceleration and for removing the funnel to simplify the home measurement procedure. Through an online platform, the physician can see and compare each UF data. The device's reliability has been validated in a first laboratory setting and showed excellent performance. This approach based on domiciliary tests and an online platform can revolutionize the urologic clinic landscape by offering a constant patient cost-effective follow-up, eliminating the time wasted waiting in the office setting.
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Affiliation(s)
- Savio Domenico Pandolfo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
- Division of Urology, Virginia Commonwealth University (VCU) Health, Richmond, VA 23298, USA
| | - Federica Crauso
- Department of Public Health, University of Naples “Federico II”, 80125 Naples, Italy
| | - Achille Aveta
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Simone Cilio
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Biagio Barone
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Luigi Napolitano
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Antonio Scarpato
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Benito Fabio Mirto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | | | - Francesco Del Giudice
- Department of Maternal-Infant and Urologic Sciences, “Sapienza” University of Rome, Policlinico Umberto I Hospital, 00161 Rome, Italy
- Department of Urology, Stanford Medical Center, Stanford, CA 94305, USA
| | - Benjamin I. Chung
- Department of Urology, Stanford Medical Center, Stanford, CA 94305, USA
| | - Fabio Crocerossa
- Urology Unit, Magna Graecia University of Catanzaro, 88100 Catanzaro, Italy
| | - Erika Di Zazzo
- Department of Medicine and Health Sciences “V. Tiberio”, University of Molise, 86100 Campobasso, Italy
| | - Francesco Trama
- Andrological and Urogynecological Clinic, Santa Maria Terni Hospital, University of Perugia, 05100 Terni, Italy
| | - Ruggero Vaglio
- Department of Physics, University of Naples “Federico II”, and CNR SPIN, 80125 Naples, Italy
| | - Zhenjie Wu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Paolo Verze
- Department of Medicine and Surgery, Scuola Medica Salernitana, University of Salerno, 84081 Fisciano, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, 80131 Naples, Italy
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10
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Crocerossa F, Autorino R, Derweesh I, Carbonara U, Cantiello F, Damiano R, Rubio-Briones J, Roupret M, Breda A, Volpe A, Mir MC. Management of renal cell carcinoma in transplant kidney: a systematic review and meta-analysis. Minerva Urol Nephrol 2023; 75:1-16. [PMID: 36094386 DOI: 10.23736/s2724-6051.22.04881-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION After transplantation, approximately 10% of renal cell carcinomas are detected in graft kidneys. These tumors (gRCC) present surgeons with the difficulty of finding a treatment that guarantees both oncological clearance and maintenance of function. We conducted a systematic review and an individual patient data meta-analysis on the oncology, safety and functional outcomes of the available treatments for gRCC. EVIDENCE ACQUISITION A systematic search was performed across MEDLINE, EMBASE, and Web of Science including any study reporting perioperative, functional and survival outcomes for patients undergoing graft nephrectomy (GN), partial nephrectomy (PN) or thermal ablation (TA) for gRCC. Quade's ANCOVA, Spearman Rho and Pearson χ2, Kaplan-Meier, Log-rank and Standard Cox regression and other tests were used to compare treatments. Studies' quality was evaluated using a modified version of Newcastle Ottawa Scale. EVIDENCE SYNTHESIS A number of 29 studies (357 patients) were included. No differences between TA and PN were found in terms of safety, functional and oncological outcomes for T1a gRCCs. When applied to pT1b gRCC, PN showed no difference in complications, progression or cancer-specific deaths compared to smaller lesions; PN validity for pT2 gRCCs should be considered unverified due to lack of sufficient evidence. The efficacy and safety of PN or TA for multiple gRCC remain controversial. In case of non-functioning, large (T≥2), complicated or metastatic gRCCs, GN appears to be the most reasonable choice. Quality of evidence ranged from very low to moderate. Studies with large cohorts and longer follow-up are still needed to clarify oncological and functional differences. CONCLUSIONS PN and TA might be offered as a nephron-sparing treatment in patients with T1a gRCC. There is no significant difference between these options and GN in terms of oncological outcomes and complications. PN and TA offer similar functional outcomes and graft preservation. PN for T1b gRCC seems feasible and safe, but its validity should be considered unverified.
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Affiliation(s)
- Fabio Crocerossa
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.,Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | | | - Umberto Carbonara
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.,Unit of Andrology and Kidney Transplantation, Department of Urology, University of Bari, Bari, Italy
| | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Jose Rubio-Briones
- Department of Urology, Instituto Valenciano Oncologia (IVO) Foundation, Valencia, Spain
| | - Morgan Roupret
- Department of Urology, GRC5 Predictive Onco-Uro, AP-HP, Pitie-Salpetriere Hospital, Sorbonne University, Paris, France
| | - Alberto Breda
- Department of Urology, Puigvert Foundation, Autonomous University of Barcelona, Barcelona, Spain
| | - Alessandro Volpe
- Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - M Carmen Mir
- Urology Department, IMED Hospitals, Valencia, Spain -
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11
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Ferro M, Crocetto F, Barone B, del Giudice F, Maggi M, Lucarelli G, Busetto GM, Autorino R, Marchioni M, Cantiello F, Crocerossa F, Luzzago S, Piccinelli M, Mistretta FA, Tozzi M, Schips L, Falagario UG, Veccia A, Vartolomei MD, Musi G, de Cobelli O, Montanari E, Tătaru OS. Artificial intelligence and radiomics in evaluation of kidney lesions: a comprehensive literature review. Ther Adv Urol 2023; 15:17562872231164803. [PMID: 37113657 PMCID: PMC10126666 DOI: 10.1177/17562872231164803] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/04/2023] [Indexed: 04/29/2023] Open
Abstract
Radiomics and artificial intelligence (AI) may increase the differentiation of benign from malignant kidney lesions, differentiation of angiomyolipoma (AML) from renal cell carcinoma (RCC), differentiation of oncocytoma from RCC, differentiation of different subtypes of RCC, to predict Fuhrman grade, to predict gene mutation through molecular biomarkers and to predict treatment response in metastatic RCC undergoing immunotherapy. Neural networks analyze imaging data. Statistical, geometrical, textural features derived are giving quantitative data of contour, internal heterogeneity and gray zone features of lesions. A comprehensive literature review was performed, until July 2022. Studies investigating the diagnostic value of radiomics in differentiation of renal lesions, grade prediction, gene alterations, molecular biomarkers and ongoing clinical trials have been analyzed. The application of AI and radiomics could lead to improved sensitivity, specificity, accuracy in detecting and differentiating between renal lesions. Standardization of scanner protocols will improve preoperative differentiation between benign, low-risk cancers and clinically significant renal cancers and holds the premises to enhance the diagnostic ability of imaging tools to characterize renal lesions.
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Affiliation(s)
| | - Felice Crocetto
- Department of Neurosciences and Reproductive
Sciences and Odontostomatology, University of Naples Federico II, Naples,
Italy
| | - Biagio Barone
- Department of Neurosciences and Reproductive
Sciences and Odontostomatology, University of Naples Federico II, Naples,
Italy
| | - Francesco del Giudice
- Department of Maternal Infant and Urologic
Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome,
Italy
| | - Martina Maggi
- Department of Maternal Infant and Urologic
Sciences, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome,
Italy
| | - Giuseppe Lucarelli
- Urology, Andrology and Kidney Transplantation
Unit, Department of Emergency and Organ Transplantation, University of Bari,
Bari, Italy
| | - Gian Maria Busetto
- Department of Urology and Organ
Transplantation, University of Foggia, Foggia, Italy
| | | | - Michele Marchioni
- Department of Medical, Oral and
Biotechnological Sciences, Urology Unit, SS Annunziata Hospital, G.
d’Annunzio University of Chieti, Chieti, Italy
- Department of Urology, ASL Abruzzo 2, Chieti,
Italy
| | - Francesco Cantiello
- Department of Urology, Magna Graecia
University of Catanzaro, Catanzaro, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia
University of Catanzaro, Catanzaro, Italy
| | - Stefano Luzzago
- Department of Urology, IEO – European
Institute of Oncology, IRCCS – Istituto di Ricovero e Cura a Carattere
Scientifico, Milan, Italy
- Università degli Studi di Milano, Milan,
Italy
| | - Mattia Piccinelli
- Cancer Prognostics and Health Outcomes Unit,
Division of Urology, University of Montréal Health Center, Montréal, QC,
Canada
- Department of Urology, IEO – European
Institute of Oncology, IRCCS – Istituto di Ricovero e Cura a Carattere
Scientifico, Milan, Italy
| | - Francesco Alessandro Mistretta
- Department of Urology, IEO – European
Institute of Oncology, IRCCS – Istituto di Ricovero e Cura a Carattere
Scientifico, Milan, Italy
- Department of Oncology and
Hematology-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Marco Tozzi
- Department of Urology, IEO – European
Institute of Oncology, IRCCS – Istituto di Ricovero e Cura a Carattere
Scientifico, Milan, Italy
- Università degli Studi di Milano, Milan,
Italy
| | - Luigi Schips
- Department of Medical, Oral and
Biotechnological Sciences, Urology Unit, SS Annunziata Hospital, G.
d’Annunzio University of Chieti, Chieti, Italy
| | | | - Alessandro Veccia
- Urology Unit, Azienda Ospedaliera
Universitaria Integrata Verona, University of Verona, Verona, Italy
| | - Mihai Dorin Vartolomei
- Department of Cell and Molecular Biology,
George Emil Palade University of Medicine, Pharmacy, Science and Technology
of Târgu Mures, Târgu Mures, Romania
- Department of Urology, Medical University of
Vienna, Vienna, Austria
| | - Gennaro Musi
- Department of Urology, IEO – European
Institute of Oncology, IRCCS – Istituto di Ricovero e Cura a Carattere
Scientifico, Milan, Italy
- Department of Oncology and
Hematology-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Ottavio de Cobelli
- Department of Urology, IEO – European
Institute of Oncology, IRCCS – Istituto di Ricovero e Cura a Carattere
Scientifico, Milan, Italy
- Department of Oncology and
Hematology-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Emanuele Montanari
- Department of Urology, Foundation IRCCS Ca’
Granda – Ospedale Maggiore Policlinico, Department of Clinical Sciences and
Community Health, University of Milan, Milan, Italy
| | - Octavian Sabin Tătaru
- Institution Organizing University Doctoral
Studies (IOSUD), George Emil Palade University of Medicine, Pharmacy,
Science and Technology of Târgu Mures, Târgu Mures, Romania
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12
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Crocerossa F, Mir MC. Racial disparities in treatment patterns for localized prostate cancer in an equal access system: What are we missing? Prostate Cancer Prostatic Dis 2022:10.1038/s41391-022-00614-6. [DOI: 10.1038/s41391-022-00614-6] [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] [Received: 09/13/2022] [Revised: 10/27/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
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13
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Manfredi C, García-Gómez B, Arcaniolo D, García-Rojo E, Crocerossa F, Autorino R, Gratzke C, De Sio M, Romero-Otero J. Impact of Surgery for Benign Prostatic Hyperplasia on Sexual Function: A Systematic Review and Meta-analysis of Erectile Function and Ejaculatory Function. Eur Urol Focus 2022; 8:1711-1732. [PMID: 35803852 DOI: 10.1016/j.euf.2022.06.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 05/02/2022] [Accepted: 06/17/2022] [Indexed: 01/25/2023]
Abstract
CONTEXT Several sexual side effects, including erectile, ejaculatory, and orgasmic dysfunction, were reported with the majority of surgical procedures for benign prostatic obstruction (BPO). OBJECTIVE To systematically review current evidence regarding the impact of benign prostatic hyperplasia (BPH) surgery on sexual function. EVIDENCE ACQUISITION A comprehensive bibliographic search on the MEDLINE, Cochrane Library, Embase, Web of Science, and Google Scholar databases was conducted in July 2021. The population, intervention, comparator, and outcome (PICO) model was used to define study eligibility. Studies were Included if they assessed patients with BPO and related lower urinary tract symptoms (P) undergoing BPH surgery (I) with or without a comparison between surgical treatments (C) evaluating the impact on sexual function (O). Retrospective and prospective primary studies were included. A pooled analysis was conducted on studies including the postoperative assessment of International Index of Erectile Function (IIEF)-5, Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD; Function and/or Bother), or retrograde ejaculation (RE) rate (PROSPERO database ID: CRD42020177907). EVIDENCE SYNTHESIS A total of 151 studies investigating 20 531 patients were included. Forty-eight randomized controlled trials evaluating 5045 individuals were eligible for the meta-analysis. In most studies (122, 80.8%), only erectile and/or ejaculatory function was evaluated. A substantial number of articles (67, 44.4%) also used nonvalidated tools to evaluate erectile and/or ejaculatory function. The pooled analysis showed no statistically significant changes in IIEF-5 score compared with baseline for the transurethral resection of the prostate (TURP; weighted mean difference [WMD] 0.76 pts; 95% confidence interval [CI] -0.1, 1.62; p = 0.08), laser procedure (WMD 0.33 pts; 95% CI -0.1, 0.77; p = 0.13), and minimally invasive treatment (WMD -1.37 pts; 95% CI -3.19, 0.44; p = 0.14) groups. A statistically significantly higher rate of RE was found after TURP (risk ratio [RR] 13.31; 95% CI 8.37, 21.17; p < 0.00001), other electrosurgical procedures (RR 34.77; 95% CI 10.58, 127.82; p < 0.00001), and the entire laser group (RR 17.37; 95% CI 5.93, 50.81; p < 0.00001). No statistically significant increase in RE rate was described after most of the minimally invasive procedures (p > 0.05). The pooled analysis of MSHQ-EjD scores was possible only for prostatic urethral lift, showing no statistically significant difference between baseline and post-treatment MSHQ-EjD Function scores (WMD -0.80 pts; 95% CI -2.41, 0.81; p = 0.33), but postoperative MSHQ-EjD Bother scores were significantly higher (WMD 0.76 pts; 95% CI 0.22, 1.30; p = 0.006). CONCLUSIONS Erectile function appears to be unaffected by most surgical procedures for BPO. RE is a very common adverse event of BPH surgery, although emerging minimally invasive surgical procedures could be associated with a lower risk. PATIENT SUMMARY Benign prostatic hyperplasia surgery can have an impact on sexual function, mainly involving ejaculatory function.
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Affiliation(s)
- Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Borja García-Gómez
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain; Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain; ROC Clinic, Madrid, Spain
| | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Esther García-Rojo
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain; ROC Clinic, Madrid, Spain
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Riccardo Autorino
- Division of Urology, Virginia Commonwealth University, Richmond, VA, USA
| | - Christian Gratzke
- Department of Urology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Marco De Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Javier Romero-Otero
- Department of Urology, HM Hospitales (Montepríncipe, Puerta del Sur, Sanchinarro), Madrid, Spain; ROC Clinic, Madrid, Spain.
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14
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Crocerossa F, Carbonara U, Veccia A, Rosiello G, Tellini R, Mari A, Mastroianni R, Ferro M, De Cobelli O, Cacciamani G, Minervini A, Simone G, Cantiello F, Damiano R, Autorino R. Preoperative predictors of postoperative complications after robot-assisted and laparoscopic radical nephroureterectomy for upper tract urothelial carcinoma. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01121-1] [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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15
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Alba S, Fimognari D, Crocerossa F, Ascalone L, Pullano C, Chiaravalloti F, Chiaradia F, Carbonara U, Ferro M, de Cobelli O, Pagliarulo V, Lucarelli G, Battaglia M, Damiano R, Cantiello F. Neuraxial anesthesia versus general anesthesia in patients undergoing three-dimensional laparoscopic radical prostatectomy: Preliminary results of a prospective comparative study. Asian J Urol 2022. [PMID: 37538165 PMCID: PMC10394281 DOI: 10.1016/j.ajur.2022.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Objective Neuraxial anesthesia (NA) showed to reduce both morbidity and mortality in patients undergoing laparoscopic surgery. We aimed to investigate the use of NA in patients undergoing transperitoneal three-dimensional laparoscopic radical prostatectomy (t-3DLRP) and compare the intraoperative and postoperative outcomes with a control group of patients undergoing t-3DLRP under general anesthesia (GA). Methods A prospective, double-center, double-surgeon study cohort of 84 consecutive patients undergoing t-3DLRP between June 2019 and June 2021 was analyzed. A study group of 42 patients undergoing t-3DLRP under NA was compared with a control group of 42 patients undergoing t-3DLRP under GA. Results The two group were similar in all demographic, clinical, and pathological variables. Postoperative blood gas parameters were within physiologic limits in both groups. Muscle relaxation was adequate for surgery during both NA and GA. Median length of stay was 1 day shorter for NA group than GA group (5 days vs. 6 days, p=0.05). t-3DLRP under NA had a statistically lower rate of minor complications (4.8% vs. 19.0%, p=0.03) and less postoperative pain (median numeric rating scale 3 vs. 4, p=0.01) compared to GA. No major complications were observed in both groups. Significantly more patients were willing to undergo a similar intervention under NA than GA (p=0.04). Conclusion t-3DLRP under NA is a feasible and safe procedure, with less postoperative pain and fewer minor complications than the same procedure under GA. NA allows the maintenance of muscle relaxation and respiratory excursions without interfering with surgery.
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16
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Tafuri A, Marchioni M, Cerrato C, Mari A, Tellini R, Odorizzi K, Veccia A, Amparore D, Shakir A, Carbonara U, Trovato F, Catellani M, Janello L, Bianchi L, Novara G, Dal Moro F, Schiavina R, De Lorenzis E, Parma P, Cimino S, de Cobelli O, Maiorino F, Bove P, Crocerossa F, Cantiello F, D’andrea D, Di Cosmo F, Porpiglia F, Ditonno P, Montanari E, Soria F, Gontero P, Liguori G, Trombetta C, Mantica G, Borghesi M, Terrone C, Del Giudice F, Sciarra A, Galosi A, Moschini M, Shariat S, Di Nicola M, Minervini A, Ferro M, Cerruto M, Schips L, Pagliarulo V, Antonelli A. Changes in renal function after nephroureterectomy for upper urinary tract carcinoma: analysis of a large multicenter cohort (radical nephroureterectomy outcomes (RANEO) research consortium). EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01230-7] [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: 11/07/2022] Open
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17
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Pandolfo S, Beksac A, Loizzo D, Derweesh I, Cerrato C, Celia A, Schiavina R, Carbonara U, Crocerossa F, Capitanio U, Kim F, Aveta A, Barone B, Del Giudice F, Mirone V, Imbimbo C, Autorino R. Robot-assisted partial nephrectomy versus percutaneous ablation for completely endophytic renal masses: a multicenter analysis with a minimum 3-year follow-up. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01303-9] [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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18
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Pandolfo SD, Aveta A, Loizzo D, Crocerossa F, La Rocca R, Del Giudice F, Chung BI, Wu Z, Lucarelli G, Mirone V, Imbimbo C, Autorino R. Quality of Web-Based Patient Information on Robotic Radical Cystectomy Remains Poor: A Standardized Assessment. Urol Pract 2022; 9:498-503. [PMID: 37145731 DOI: 10.1097/upj.0000000000000335] [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] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Patients frequently use the Web to obtain health information. This trend increased during the COVID19 pandemic. We aimed to assess the quality of Web-based information on robot-assisted radical cystectomy. METHODS A Web search was conducted in November 2021 using the 3 most common engines (Google/Bing/Yahoo). Search terms were "robotic cystectomy," "robot-assisted cystectomy," and "robotic radical cystectomy." The top 25 results generated for each term by each search engine were included. Duplicate pages, pages advertised, and pages with paywall access were excluded. Selected websites were classified as academic, physician, commercial, and unspecified. The quality of site contents was evaluated using the DISCERN and Journal of the American Medical Association (JAMA) assessment instruments, and HONcode (Health on the Net Foundation) seal and reference presence. Flesch Reading Ease Score was used for readability assessment. RESULTS Of the 225 sites examined only 34 were eligible for analysis, including 35.3% classified as "academic," 44.1% "physician," 11.8% "commercial," and 8.8% "unspecified." Average±SD DISCERN and JAMA scores were 45.5±15.7 and 1.9±1.1, respectively. Commercial websites had the highest DISCERN and JAMA scores with a mean±SD of 64.7±8.7 and 3.6±0.5, respectively. Physician websites had a significantly lower JAMA mean score than commercial ones (p <0.001). Six websites had HONcode seals and 10 reported references. Readability was difficult as it was at the level of college graduate. CONCLUSIONS As the role of robot-assisted radical cystectomy continues to grow worldwide, the overall quality of Web-based information related to this procedure remains poor. An effort should be made by health care providers to assure patients can have better access to reliable and readable informational material.
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Affiliation(s)
- Savio Domenico Pandolfo
- Division of Urology, VCH Health, Richmond, Virginia
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Fderico II University, Naples, Italy
| | - Achille Aveta
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Fderico II University, Naples, Italy
| | - Davide Loizzo
- Division of Urology, VCH Health, Richmond, Virginia
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Fabio Crocerossa
- Division of Urology, VCH Health, Richmond, Virginia
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Roberto La Rocca
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Fderico II University, Naples, Italy
| | - Francesco Del Giudice
- Department of Urology, School of Medicine, Stanford University, Stanford, California
| | - Benjamin I Chung
- Department of Urology, School of Medicine, Stanford University, Stanford, California
| | - Zhenjie Wu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Vincenzo Mirone
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Fderico II University, Naples, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Sciences of Reproduction, and Odontostomatology, Fderico II University, Naples, Italy
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Manfredi C, Arcaniolo D, Amicuzi U, Spirito L, Napolitano L, Crocerossa F, Paoletta M, Gisone S, Cirillo P, Crocetto F, Bellastella G, De Sio M, Imbimbo C. Impact of extracorporeal shockwave therapy for erectile dysfunction and peyronie's disease on reproductive and hormonal testicular function. Andrology 2022; 10:1368-1375. [PMID: 35909300 PMCID: PMC9540478 DOI: 10.1111/andr.13240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 06/24/2022] [Revised: 07/12/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
Introduction Extracorporeal shock wave therapy is an established treatment for erectile dysfunction and Peyronie's disease. Concerns regarding the safety of extracorporeal shock wave therapy for andrological purposes on testicular function were raised by animal studies. Aim To evaluate the impact of extracorporeal shock wave therapy for erectile dysfunction or Peyronie's disease on reproductive and hormonal testicular function. Methods We designed a prospective controlled study in which consecutive patients were enrolled. Males aged between 18 and 40 years with mild vasculogenic erectile dysfunction or acute inflammatory Peyronie's disease and normozoospermia were included. All enrolled patients were offered extracorporeal shock wave therapy, and subjects who refused extracorporeal shock wave therapy for any reason were considered as the Control group. All patients in the Intervention group were treated with DUOLITH SD1 T‐TOP by a single expert urologist. Semen analysis and serum total testosterone dosage were performed before the start (T0) and 3 months after the end of extracorporeal shock wave therapy (T1) in Intervention group. The same parameters were evaluated after the extracorporeal shock wave therapy refusal (T0) and at the end of the following 3 months (T1) in Control group. Normozoospermia was chosen as the primary outcome, serum total testosterone concentration was selected as the secondary outcome. Results A total of 94 patients were enrolled in the study (48 Group A, 46 Group B). At T0, all patients were normozoospermic in both groups (p = 0.563), and no significant difference in mean ± SD total testosterone levels was recorded between the groups (582.5 ± 107.2 vs. 634.6 ± 108.4 ng/dl; p = 0.221). At T1, no significant deterioration (p > 0.05) in semen parameters was recorded in both groups. Only a statistically significant reduction in seminal pH was found after extracorporeal shock wave therapy compared to baseline (7.9 ± 0.3 vs. 7.5 ± 0.2; p < 0.001) and untreated patients (7.8 ± 0.2 vs. 7.5 ± 0.2; p < 0.001). No significant difference in total testosterone levels was recorded in Intervention group after extracorporeal shock wave therapy compared to baseline (p = 0.584). Conclusion Extracorporeal shock wave therapy in erectile dysfunction and Peyronie's disease patients does not seem to affect reproductive and hormonal testicular function.
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Affiliation(s)
- Celeste Manfredi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery University of Campania “Luigi Vanvitelli” Naples Italy
| | - Davide Arcaniolo
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery University of Campania “Luigi Vanvitelli” Naples Italy
| | - Ugo Amicuzi
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery University of Campania “Luigi Vanvitelli” Naples Italy
| | - Lorenzo Spirito
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery University of Campania “Luigi Vanvitelli” Naples Italy
| | - Luigi Napolitano
- Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology University of Naples “Federico II” Naples Italy
| | - Fabio Crocerossa
- Department of Urology Magna Graecia University of Catanzaro Catanzaro Italy
| | - Marco Paoletta
- Department of Mental and Physical Health and Preventive Medicine University of Campania “Luigi Vanvitelli” Naples Italy
| | - Stefano Gisone
- Department of Emergency and Organ Transplantation‐Urology, Andrology and Kidney Transplantation Unit University of Bari Bari Italy
| | - Paolo Cirillo
- Unit of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences University of Campania “Luigi Vanvitelli” Naples Italy
| | - Felice Crocetto
- Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology University of Naples “Federico II” Naples Italy
| | - Giuseppe Bellastella
- Unit of Endocrinology and Metabolic Diseases, Department of Advanced Medical and Surgical Sciences University of Campania “Luigi Vanvitelli” Naples Italy
| | - Marco De Sio
- Unit of Urology, Department of Woman, Child and General and Specialized Surgery University of Campania “Luigi Vanvitelli” Naples Italy
| | - Ciro Imbimbo
- Unit of Urology, Department of Neurosciences, Reproductive Sciences, and Odontostomatology University of Naples “Federico II” Naples Italy
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20
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Carbonara U, Amparore D, Gentile C, Bertolo R, Erdem S, Ingels A, Marchioni M, Muselaers CH, Kara O, Marandino L, Pavan N, Roussel E, Pecoraro A, Crocerossa F, Torre G, Campi R, Ditonno P. Current strategies to diagnose and manage of positive surgical margins and local recurrence after partial nephrectomy. Asian J Urol 2022; 9:227-242. [PMID: 36035342 PMCID: PMC9399527 DOI: 10.1016/j.ajur.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022] Open
Abstract
Objective No standard strategy for diagnosis and management of positive surgical margin (PSM) and local recurrence after partial nephrectomy (PN) are reported in literature. This review aims to provide an overview of the current strategies and further perspectives on this patient setting. Methods A non-systematic review of the literature was completed. The research included the most updated articles (about the last 10 years). Results Techniques for diagnosing PSMs during PN include intraoperative frozen section, imprinting cytology, and other specific tools. No clear evidence is reported about these methods. Regarding PSM management, active surveillance with a combination of imaging and laboratory evaluation is the first option line followed by surgery. Regarding local recurrence management, surgery is the primary curative approach when possible but it may be technically difficult due to anatomy resultant from previous PN. In this scenario, thermal ablation (TA) may have the potential to circumvent these limitations representing a less invasive alternative. Salvage surgery represents a valid option; six studies analyzed the outcomes of nephrectomy on local recurrence after PN with three of these focused on robotic approach. Overall, complication rates of salvage surgery are higher compared to TA but ablation presents a higher recurrence rate up to 25% of cases that can often be managed with repeat ablation. Conclusion Controversy still exists surrounding the best strategy for management and diagnosis of patients with PSMs or local recurrence after PN. Active surveillance is likely to be the optimal first-line management option for most patients with PSMs. Ablation and salvage surgery both represent valid options in patients with local recurrence after PN. Conversely, salvage PN and radical nephrectomy have fewer recurrences but are associated with a higher complication rate compared to TA. In this scenario, robotic surgery plays an important role in improving salvage PN and radical nephrectomy outcomes.
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Affiliation(s)
- Umberto Carbonara
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
- Corresponding author. Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy.
| | - Daniele Amparore
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Cosimo Gentile
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Riccardo Bertolo
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Department of Urology, San Carlo Di Nancy Hospital, Rome, Italy
| | - Selcuk Erdem
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Division of Urologic Oncology, Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Alexandre Ingels
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Department of Urology, University Hospital Henri Mondor, APHP, Créteil, France
| | - Michele Marchioni
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Department of Urology, SS Annunziata Hospital, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Constantijn H.J. Muselaers
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Department of Urology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Onder Kara
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Department of Urology, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Laura Marandino
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Department of Medical Oncology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Nicola Pavan
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Urology Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy
| | - Eduard Roussel
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Department of Urology, University Hospitals Leuven, Leuven, Belgium
| | - Angela Pecoraro
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giuseppe Torre
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Riccardo Campi
- European Association of Urology (EAU), Young Academic Urologists (YAU), Renal Cancer Working Group
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
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Loizzo D, Pandolfo SD, Crocerossa F, Guruli G, Ferro M, Paul AK, Imbimbo C, Lucarelli G, Ditonno P, Autorino R. Current Management of Urachal Carcinoma: An Evidence-based Guide for Clinical Practice. EUR UROL SUPPL 2022; 39:1-6. [PMID: 35309098 PMCID: PMC8927909 DOI: 10.1016/j.euros.2022.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 02/07/2023] Open
Abstract
Urachal carcinoma is a rare urological disease. The shortage of data about diagnosis and surgical treatment in literature makes it hard for clinicians to make a decision. Indeed, urachal carcinoma is an aggressive disease that requires prompt staging and treatment to ensure the best outcome for patients. We reviewed the last evidence about the management of urachal carcinoma to provide an easy-to-use guide for clinical practice. Patient summary Urachal carcinoma is a rare malignancy. The literature on this challenging disease remains limited. Herein, we provide a practical guide for its management from diagnosis to treatment, which in most cases requires surgical intervention or chemotherapy.
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Crocerossa F, Fiori C, Capitanio U, Minervini A, Carbonara U, Pandolfo SD, Loizzo D, Eun DD, Larcher A, Mari A, Grosso AA, Di Maida F, Hampton LJ, Cantiello F, Damiano R, Porpiglia F, Autorino R. Estimated Glomerular Filtration Rate Decline at 1 Year After Minimally Invasive Partial Nephrectomy: A Multimodel Comparison of Predictors. EUR UROL SUPPL 2022; 38:52-59. [PMID: 35495283 PMCID: PMC9051959 DOI: 10.1016/j.euros.2022.02.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [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] [Accepted: 02/11/2022] [Indexed: 12/12/2022] Open
Abstract
Background Long-term renal function after partial nephrectomy (PN) is difficult to predict as it is influenced by several modifiable and nonmodifiable variables, often intertwined in complex relations. Objective To identify variables influencing long-term renal function after PN and to assess their relative weight. Design, setting, and participants A total of 457 patients who underwent either robotic (n = 412) or laparoscopic PN (n = 45) were identified from a multicenter international database. Outcome measurements and statistical analysis The 1-yr estimated glomerular filtration rate (eGFR) percentage loss (1YPL), defined as the eGFR percentage change from baseline at 1 yr after surgery, was the outcome endpoint. Predictors evaluated included demographic data, tumor features, and operative and postoperative variables. Bayesian multimodel analysis of covariance was used to build all possible models and compare the fit of each model to the data via model Bayes factors. Bayesian model averaging was used to quantify the support for each predictor via the inclusion Bayes factor (BFincl). High-dimensional undirected graph estimation was used for network analysis of conditional independence between predictors. Results and limitations Several models were found to be plausible for estimation of 1YPL. The best model, comprising postoperative eGFR percentage loss (PPL), sex, ischemia technique, and preoperative eGFR, was 207 times more likely than all the other models regarding relative predictive performance. Its components were part of the top 44 models and were the predictors with the highest BFincl. The role of cold ischemia, solitary kidney status, surgeon experience, and type of renorraphy was not assessed. Conclusions Preoperative eGFR, sex, ischemia technique, and PPL are the best predictors of eGFR percentage loss at 1 yr after minimally invasive PN. Other predictors seem to be irrelevant, as their influence is insignificant or already nested in the effect of these four parameters. Patient summary Kidney function at 1 year after partial removal of a kidney depends on sex, the technique used to halt blood flow to the kidney during surgery, and kidney function at baseline and in the early postoperative period.
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Affiliation(s)
- Fabio Crocerossa
- Division of Urology, VCU Health, Richmond, VA, USA
- Department of Urology, Magna Graecia University, Catanzaro, Italy
| | - Cristian Fiori
- Division of Urology, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Umberto Capitanio
- Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, University of Florence, Florence, Italy
| | - Umberto Carbonara
- Division of Urology, VCU Health, Richmond, VA, USA
- Department of Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | | | | | - Daniel D. Eun
- Department of Urology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Alessandro Larcher
- Unit of Urology, Division of Experimental Oncology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, University of Florence, Florence, Italy
| | - Antonio Andrea Grosso
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, University of Florence, Florence, Italy
| | - Fabrizio Di Maida
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, Careggi University Hospital, University of Florence, Florence, Italy
| | | | | | - Rocco Damiano
- Department of Urology, Magna Graecia University, Catanzaro, Italy
| | - Francesco Porpiglia
- Division of Urology, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Riccardo Autorino
- Division of Urology, VCU Health, Richmond, VA, USA
- Corresponding author. Division of Urology, VCU Health, West Hospital, 1200 East Broad Street, Richmond, VA 23298, USA. Tel. +1 804 8273099; Fax: +1 804 8282157.
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Falagario UG, Sanguedolce F, Dovey Z, Carbonara U, Crocerossa F, Papastefanou G, Autorino R, Recchia M, Ninivaggi A, Busetto GM, Annese P, Carrieri G, Cormio L. Prostate cancer biomarkers: a practical review based on different clinical scenarios. Crit Rev Clin Lab Sci 2022; 59:297-308. [PMID: 35200064 DOI: 10.1080/10408363.2022.2033161] [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] [Indexed: 12/24/2022]
Abstract
Traditionally, diagnosis and staging of prostate cancer (PCa) have been based on prostate-specific antigen (PSA) level, digital rectal examination (DRE), and transrectal ultrasound (TRUS) guided prostate biopsy. Biomarkers have been introduced into clinical practice to reduce the overdiagnosis and overtreatment of low-grade PCa and increase the success of personalized therapies for high-grade and high-stage PCa. The purpose of this review was to describe available PCa biomarkers and examine their use in clinical practice. A nonsystematic literature review was performed using PubMed and Scopus to retrieve papers related to PCa biomarkers. In addition, we manually searched websites of major urological associations for PCa guidelines to evaluate available evidence and recommendations on the role of biomarkers and their potential contribution to PCa decision-making. In addition to PSA and its derivates, thirteen blood, urine, and tissue biomarkers are mentioned in various PCa guidelines. Retrospective studies have shown their utility in three main clinical scenarios: (1) deciding whether to perform a biopsy, (2) distinguishing patients who require active treatment from those who can benefit from active surveillance, and (3) defining a subset of high-risk PCa patients who can benefit from additional therapies after RP. Several validated PCa biomarkers have become commercially available in recent years. Guidelines now recommend offering these tests in situations in which the assay result, when considered in combination with routine clinical factors, is likely to affect management. However, the lack of direct comparisons and the unproven benefits, in terms of long-term survival and cost-effectiveness, prevent these biomarkers from being integrated into routine clinical use.
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Affiliation(s)
- Ugo Giovanni Falagario
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy.,Division of Urology, VCU Health System, Richmond, VA, USA.,Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Zach Dovey
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - George Papastefanou
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Marco Recchia
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Antonella Ninivaggi
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Gian Maria Busetto
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Pasquale Annese
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Giuseppe Carrieri
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
| | - Luigi Cormio
- Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy
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Carbonara U, Crocerossa F, Mehrazin R, Campi R, Marchioni M, Morlacco A, Pagliarulo V, Wu Z, Autorino R, Stein RJ, Eun D, Ditonno P, Dal Moro F. Robotic ureteral reimplantation: systematic review and pooled analysis of comparative outcomes in adults. Minerva Urol Nephrol 2022; 74:161-168. [PMID: 35147383 DOI: 10.23736/s2724-6051.21.04558-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The surgical treatment of ureteral strictures in adults represents a challenging procedure for the variability of location, extension, and etiology of the disease. Open ureteral reimplantation (OUR) offered high success rates even when considering complex ureteral disease. The debate for defining the role of robotic in the treatment of adult ureteral disease is still ongoing. The aim of the current systematic review is to provide an updated analysis of the comparative outcomes of robot-assisted UR (RAUR) versus OUR based on the available literature. EVIDENCE ACQUISITION An independent systematic review of the literature was performed from 2010 to 2021. Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) recommendations were followed to design search strategies, selection criteria, and evidence reports. The quality of the included studies was determined using the Newcastle-Ottawa scale for nonrandomized controlled trials. Pooled analysis of demographics and clinical characteristics, as well as surgical and postoperative outcomes, was performed. EVIDENCE SYNTHESIS After an initial screening and full-text review, 5 studies published between 2002 and 2021 were identified and included in the analysis. All the studies were observational retrospective case-control studies. Among the 225 patients included in the pooled analysis, 94 (41.8%) and 131 (58.2%) were RAUR and OUR, respectively. There was no difference between groups in terms of baseline characteristics. No differences in surgical approach and operative time were reported among the groups. Estimated blood loss was lower for robotic approach (WMD: -121.71ml; p=0.0006). There were no significant differences between groups in overall (OR: 0.85; p=0.69) and major (OR:0.69; p=0.52) complication. RAUR group reported shorter length of stay (WMD: -2.39day; p<0.00001), catheter (WMD: -5.26day; p=0.004) and stent (WMD: -11.9day; p=0.001) time. CONCLUSIONS Available evidence shows that RAUR offers similar surgical outcomes if compared to OUR, and potential advantages in terms of lower blood loss, shorter hospital stay, catheter, and stent time. The adoption of one approach over the other is likely to be mainly dictated by the surgeon's preference and expertise.
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Affiliation(s)
- Umberto Carbonara
- Division of Urology, VCU Health, Richmond, VA, USA - u.carbonaragmail.com.,Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation-Urology, University of Bari, Bari, Italy - u.carbonaragmail.com
| | - Fabio Crocerossa
- Division of Urology, VCU Health, Richmond, VA, USA.,Department of Urology, Magna Graecia University, Catanzaro, Italy
| | - Reza Mehrazin
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Riccardo Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.,Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Michele Marchioni
- Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University of Chieti, Chieti, Italy
| | - Alessandro Morlacco
- Urology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Vincenzo Pagliarulo
- Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation-Urology, University of Bari, Bari, Italy
| | - Zhenjie Wu
- Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China.,Department of Urology, Changzheng Hospital, Naval Medical University, Shanghai, China 11 Department of Urology, Cleveland Clinic Foundation, Cleveland, OH, USA
| | | | - Robert J Stein
- Department of Urology, Temple University School of Medicine, Philadelphia, PA, USA
| | | | - Pasquale Ditonno
- Andrology and Kidney Transplantation Unit, Department of Emergency and Organ Transplantation-Urology, University of Bari, Bari, Italy
| | - Fabrizio Dal Moro
- Urology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
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25
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Crocerossa F, Autorino R, Derweesh I, Carbonara U, Cantiello F, Damiano R, Rubio-Briones J, Roupret M, Breda A, Volpe A, Mir M. Management of renal cell carcinoma in transplant kidney: An individual patient data meta-analysis and evidence-based guide. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00312-8] [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: 11/28/2022]
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26
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Crocerossa F, Capitanio U, Minervini A, Carbonara U, Eun D, Cantiello F, Damiano R, Porpiglia F, Autorino R. What’s the best model to predict eGFR loss at 1 year after minimally invasive partial nephrectomy? Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00143-9] [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: 11/16/2022]
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Veccia A, Carbonara U, Djaladat H, Mehrazin R, Eun D, Reese AC, Meng X, Uzzo R, Srivastava A, Porter JR, Farrow J, Jamil M, Rosiello G, Tellini R, Mari A, Al-Qathani A, Rha KH, Wang L, Mastroianni R, Ferro M, De Cobelli O, Hakimi K, Crocerossa F, Ghoreifi A, Cacciamani G, Amit S Bhattu A, Mottrie A, Abdollah F, Minervini A, Wu Z, Simone G, Derweesh IH, Gonzalgo ML, Margulis V, Sundaram CP, Autorino R. Robotic vs laparoscopic nephroureterectomy for upper tract urothelial carcinoma: a multicenter propensity-score matched pair "tetrafecta" analysis (ROBUUST collaborative group). J Endourol 2022; 36:752-759. [PMID: 35019760 DOI: 10.1089/end.2021.0587] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To compare the outcomes of robotic radical nephroureterectomy (RRNU) and laparoscopic radical nephroureterectomy (LRNU) within a large multi-institutional worldwide dataset. MATERIAL AND METHODS The ROBotic surgery for Upper tract Urothelial cancer STudy (ROBUUST) includes data from 17 centers worldwide regarding 877 RRNU and LRNU performed between 2015 and 2019. Baseline features, perioperative and oncological outcomes, were included. A 2:1 nearest-neighbor propensity-score matching with a 0.001 caliper was performed. An univariable and a multivariable logistic regression model were built to evaluate the predictors of a composite "tetrafecta" outcome defined as occurrence of bladder cuff excision + LND + no complications + negative surgical margins. RESULTS After matching, 185 RRNU and 91 LRNU were assessed. Patients in the RRNU group were more likely to undergo bladder cuff excision (81.9% vs 63.7%; p<0.001) compared to the LRNU group. A statistically significant difference was found in terms of overall postoperative complications (p=0.003) and length of stay (p<0.001) in favor of RRNU. Multivariable analysis demonstrated that LRNU was an independent predictor negatively associated with achievement of "tetrafecta" (OR: 0.09; p=0.003). CONCLUSIONS In general, RRNU and LRNU offer comparable outcomes. While the rate of overall complications is higher for LRNU in this study population, this is mostly related to low grade complications, and therefore with more limited clinical relevance. RRNU seems to offer shorter hospital stay but this might also be related to the different geographical location of participating centers. Overall, the implementation of robotics might facilitate achievement of a "tetrafecta" outcome as defined in the present study.
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Affiliation(s)
- Alessandro Veccia
- Spedali Civili Hospital, University of Brescia, Department of Urology, Piazzale Spedali Civili 1, Brescia, Italy, 25123;
| | - Umberto Carbonara
- Virginia Commonwealth University Health System, 6887, Department of Urology, 11200 E BROAD ST, RICHMOND, Richmond, Virginia, United States, 23233.,Università degli Studi di Bari Aldo Moro, 9295, Department of Urology, Bari, Puglia, Italy;
| | | | - Reza Mehrazin
- Mount Sinai Health System, 5944, Urology, 5 East 98th St, 6th floor, New York, New York, United States, 10029;
| | - Daniel Eun
- Temple University, Urology, 255 South 17th street, 7th Floor Urology Suite, Philadelphia, Pennsylvania, United States, 19103;
| | - Adam C Reese
- Lewis Katz School of Medicine at Temple University, Urology, 3401 N Broad St., Suite 340, Philadelphia, Pennsylvania, United States, 19140;
| | - Xiaosong Meng
- University of Texas Southwestern Medical Center, Urology, Dallas, Texas, United States;
| | - Robert Uzzo
- Fox Chase Cancer Center, 6565, 333 Cottman Ave, Philadelphia, Pennsylvania, United States, 19111;
| | | | - James Robert Porter
- Swedish Medical Center, Urology, 1101 Madison, Suite 1400, Seattle, Washington, United States, 98104;
| | - Jason Farrow
- Indiana University Health, 22529, Urology, 535 N Barnhill, Suite 150, Indianapolis, Indiana, United States, 46206-1367;
| | | | - Giuseppe Rosiello
- San Raffaele Hospital, 9372, Urology, Via Olgettina, 52, Milano, Italy, 20132;
| | - Riccardo Tellini
- University Hospital Careggi, 18561, Department of Oncologic, Minimally-Invasive Urology and Andrology, Largo Brambilla 3, Florence, Toscana, Italy, 50134;
| | - Andrea Mari
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy., Urology, Largo Brambilla 3, Firenze, Italy, 50100.,University of Florence, Careggi Hospital, Florence, Italy.;
| | | | - Koon Ho Rha
- Severance Hospital, Yonsei University, Urology, Yonseiro 50-1, Seodaemun-gu, Seoul, Korea, Seoul, Korea (the Republic of);
| | - Linhui Wang
- Changzheng Hospital, 56652, Shanghai, Shanghai, China;
| | | | - Matteo Ferro
- Istituto Europeo di Oncologia, 9290, Urology , via ripamonti 435, Milano, Italy, 90020.,Italy;
| | | | | | - Fabio Crocerossa
- Virginia Commonwealth University, 6889, 1200 E Broad St, Richmond, Virginia, United States, 23284-2512;
| | | | - Giovanni Cacciamani
- AOUI Azienda Ospedaliera Universitaria Integrata, Urology, Piazzale Stefani 1, Verona, Italy, 37100;
| | | | - Alexandre Mottrie
- Onze Lieve Vrouwziekenhuis, 37467, Dep. of Urology, Aalst, Belgium, 9300;
| | - Firas Abdollah
- Henry Ford Health System, Vattikuti Urology Institute, Center for Outcomes Research Analytics and Evaluation, 2799 West Grand Boulevard, Detroit, Michigan, United States, 48202;
| | - Andrea Minervini
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy., Urology, Clinica Urologica I, Azienda Ospedaliera Careggi, Università di Firenze., Largo Brambilla 3 - San Luca Nuovo Padiglione 16/Settore C/Piano II, Florence, Italy, 50134;
| | - Zhenjie Wu
- Changhai hospital, the second military medical university, the department of Urology, Changhai Road NO. 163, Shanghai, Shanghai, China, 200433;
| | - Giuseppe Simone
- Regina Elena, urology, via elio chianesi 53, Roma, Italy, 00144.,Italy;
| | - Ithaar H Derweesh
- University of California - San Diego, Urology, La Jolla, California, United States;
| | - Mark L Gonzalgo
- university of Miami, Miller School of Medicine, urology, Miami, Florida, United States;
| | - Vitaly Margulis
- UT Southwestern Medical, Urology, 5339 harry hines blvd, Dallas, Texas, United States, 75390;
| | - Chandru P Sundaram
- Indiana University School of Medicine, Urology, 535 N Barnhill Dr, Suite 420, Indianapolis, Indiana, United States, 46202;
| | - Riccardo Autorino
- Virginia Commonwealth University Health System, 6887, Surgery (Urology), 1200 East Broad st, Richmond, Virginia, United States, 23298;
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Salatino A, Mirabelli M, Chiefari E, Greco M, Di Vito A, Bonapace G, Brunetti FS, Crocerossa F, Epstein AL, Foti DP, Brunetti A. The anticancer effects of Metformin in the male germ tumor SEM-1 cell line are mediated by HMGA1. Front Endocrinol (Lausanne) 2022; 13:1051988. [PMID: 36506071 PMCID: PMC9727077 DOI: 10.3389/fendo.2022.1051988] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Germ cell tumors (GCTs) are the most common type of cancer in young men. These tumors usually originate from the testis, but they can occasionally develop from extragonadal sites probably due to primordial germ cells (PGCs) migration errors. Cisplatin-based chemotherapy is usually effective for male GCTs, but the risk of toxicity is high and new therapeutic strategies are needed. Although Metformin (Met) has been widely studied as a potential cancer treatment over the past decades, there is limited evidence to support its use in treating male GCTs. Additionally, the mechanism by which it acts on tumor cells is still not entirely understood. METHODS SEM-1 cells, a newly established human cell line of extragonadal origin, were treated with Met. Cell viability was studied by MTT assay, while cell migration and invasion were studied by the wound healing assay and the transwell assay, respectively. The effect of Met on 3D spheroid formation was determined by seeding SEM-1 cells in appropriate cell suspension culture conditions, and cell cycle was characterized by flow cytometry. Factors involved in PGCs migration and GCT invasion, such as IGFBP1, IGF1R, MMP-11 and c-Kit, together with cyclin D1 (a key regulator of cell cycle progression), and the upstream factor, HMGA1, were determined by immunoblots. RESULTS Treatment of SEM-1 cells with Met resulted in a potent and dose-dependent reduction of cell proliferation, as evidenced by decreased nuclear abundance of cyclin D1 and cell cycle arrest in G1 phase. Also, Met prevented the formation of 3D spheroids, and blocked cell migration and invasion by reducing the expression of IGFBP1, IGF1R and MMP-11. Both, IGFBP1 and MMP-11 are under control of HMGA1, a chromatin-associated protein that is involved in the regulation of important oncogenic, metabolic and embryological processes. Intriguingly, an early reduction in the nuclear abundance of HMGA1 occurred in SEM-1 cells treated with Met. CONCLUSIONS Our results document the antiproliferative and antimigratory effects of Met in SEM-1 cells, providing new insights into the potential treatments for male GCTs. The anticancer properties of Met in SEM-1 cells are likely related to its ability to interfere with HMGA1 and downstream targets, including cyclin D1, the IGFs system, and MMP-11.
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Affiliation(s)
- Alessandro Salatino
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
| | - Maria Mirabelli
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
| | - Eusebio Chiefari
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
| | - Marta Greco
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
| | - Anna Di Vito
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
| | - Giuseppe Bonapace
- Department of Medical and Surgical Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
| | - Francesco S. Brunetti
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
| | - Fabio Crocerossa
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
| | - Alan L. Epstein
- Department of Pathology, USC Keck School of Medicine, Los Angeles, CA, United States
| | - Daniela P. Foti
- Department of Experimental and Clinical Medicine, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
| | - Antonio Brunetti
- Department of Health Sciences, University “Magna Græcia” of Catanzaro, Catanzaro, Italy
- *Correspondence: Antonio Brunetti,
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29
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Crocerossa F, Visser W, Carbonara U, Falagario UG, Pandolfo SD, Loizzo D, Imbimbo C, Klausner AP, Porpiglia F, Damiano R, Cantiello F, Autorino R. The impact of COVID 19 pandemic on urology literature: a bibliometric analysis. Cent European J Urol 2022; 75:102-109. [PMID: 35591965 PMCID: PMC9074064 DOI: 10.5173/ceju.2021.291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 12/12/2021] [Revised: 12/27/2021] [Accepted: 12/28/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction The COVID-19 pandemic has caused wide-reaching change to many aspects of life on a worldwide scale. The impact of these changes on peer-reviewed research journals, including those dedicated to urology, is still unknown. Material and methods The Web of Science database was queried to retrieve all COVID-19 urological articles written in English language and published between January 1st, 2020 and December 10th, 2021. Only original and review articles were considered. A bibliometric analysis of the total number of papers, citations, institutions and publishing journals was performed. Non-COVID-19 publications were also retrieved to compare the duration of publication stages. Results A total of 428 COVID-19 articles and 14,874 non-COVID-19 articles were collected. Significant differences in the duration of all the publication stages were found between COVID-19 and non-COVID-19 articles (all p <0.001). The most productive countries were the USA (100 articles), Italy (59 articles) and the United Kingdom (55 articles). The published literature has focused on four topics: COVID-19 genitourinary manifestations, management of urological diseases during the pandemic, repercussions on quality of life and impact on healthcare providers. Conclusions A significant reduction in peer review time for COVID-19 articles might raise concerns regarding the quality of peer review itself. USA, Italy and UK published the highest number of COVID-19 related articles. Restrictive measures taken by governments to reduce the spread of infection had a strong impact on mental stress and anxiety of patients and healthcare professionals. A coerced deferral of diagnosis and treatment of emergencies and uro-oncological cases represented the most challenging task from a clinical standpoint.
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Affiliation(s)
- Fabio Crocerossa
- Division of Urology, VCU Health, Richmond, Virginia, USA
- Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - William Visser
- Division of Urology, VCU Health, Richmond, Virginia, USA
| | - Umberto Carbonara
- Division of Urology, VCU Health, Richmond, Virginia, USA
- Department of Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Ugo Giovanni Falagario
- Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Savio Domenico Pandolfo
- Division of Urology, VCU Health, Richmond, Virginia, USA
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Davide Loizzo
- Division of Urology, VCU Health, Richmond, Virginia, USA
- Department of Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Ciro Imbimbo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy
| | | | - Francesco Porpiglia
- Division of Urology, San Luigi Hospital University of Turin, Orbassano, Italy
| | - Rocco Damiano
- Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Cantiello
- Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Tafuri A, Marchioni M, Cerrato C, Mari A, Tellini R, Odorizzi K, Veccia A, Amparore D, Shakir A, Carbonara U, Panunzio A, Trovato F, Catellani M, Janello LMI, Bianchi L, Novara G, Dal Moro F, Schiavina R, De Lorenzis E, Parma P, Cimino S, De Cobelli O, Maiorino F, Bove P, Crocerossa F, Cantiello F, D’Andrea D, Di Cosmo F, Porpiglia F, Ditonno P, Montanari E, Soria F, Gontero P, Liguori G, Trombetta C, Mantica G, Borghesi M, Terrone C, Del Giudice F, Sciarra A, Galosi A, Moschini M, Shariat SF, Di Nicola M, Minervini A, Ferro M, Cerruto MA, Schips L, Pagliarulo V, Antonelli A. Changes in renal function after nephroureterectomy for upper urinary tract carcinoma: analysis of a large multicenter cohort (Radical Nephroureterectomy Outcomes (RaNeO) Research Consortium). World J Urol 2022; 40:2771-2779. [PMID: 36203101 PMCID: PMC9617815 DOI: 10.1007/s00345-022-04156-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/15/2022] [Indexed: 02/01/2023] Open
Abstract
PURPOSE To investigate prevalence and predictors of renal function variation in a multicenter cohort treated with radical nephroureterectomy (RNU) for upper tract urothelial carcinoma (UTUC). METHODS Patients from 17 tertiary centers were included. Renal function variation was evaluated at postoperative day (POD)-1, 6 and 12 months. Timepoints differences were Δ1 = POD-1 eGFR - baseline eGFR; Δ2 = 6 months eGFR - POD-1 eGFR; Δ3 = 12 months eGFR - 6 months eGFR. We defined POD-1 acute kidney injury (AKI) as an increase in serum creatinine by ≥ 0.3 mg/dl or a 1.5 1.9-fold from baseline. Additionally, a cutoff of 60 ml/min in eGFR was considered to define renal function decline at 6 and 12 months. Logistic regression (LR) and linear mixed (LM) models were used to evaluate the association between clinical factors and eGFR decline and their interaction with follow-up. RESULTS A total of 576 were included, of these 409(71.0%) and 403(70.0%) had an eGFR < 60 ml/min at 6 and 12 months, respectively, and 239(41.5%) developed POD-1 AKI. In multivariable LR analysis, age (Odds Ratio, OR 1.05, p < 0.001), male gender (OR 0.44, p = 0.003), POD-1 AKI (OR 2.88, p < 0.001) and preoperative eGFR < 60 ml/min (OR 7.58, p < 0.001) were predictors of renal function decline at 6 months. Age (OR 1.06, p < 0.001), coronary artery disease (OR 2.68, p = 0.007), POD-1 AKI (OR 1.83, p = 0.02), and preoperative eGFR < 60 ml/min (OR 7.80, p < 0.001) were predictors of renal function decline at 12 months. In LM models, age (p = 0.019), hydronephrosis (p < 0.001), POD-1 AKI (p < 0.001) and pT-stage (p = 0.001) influenced renal function variation (ß 9.2 ± 0.7, p < 0.001) during follow-up. CONCLUSION Age, preoperative eGFR and POD-1 AKI are independent predictors of 6 and 12 months renal function decline after RNU for UTUC.
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Affiliation(s)
- Alessandro Tafuri
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126 Verona, Italy ,grid.417011.20000 0004 1769 6825Department of Urology, “Vito Fazzi” Hospital, Lecce Piazza Filippo Muratore, 1, 73100 Lecce, Italy ,grid.412451.70000 0001 2181 4941Department of Neuroscience, Imaging and Clinical Sciences, G. D’Annunzio University, Chieti, Italy
| | - Michele Marchioni
- grid.412451.70000 0001 2181 4941Department of Urology, University of Chieti, Chieti, Italy
| | - Clara Cerrato
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126 Verona, Italy
| | - Andrea Mari
- grid.8404.80000 0004 1757 2304Department of Urology, University of Florence, Florence, Italy
| | - Riccardo Tellini
- grid.8404.80000 0004 1757 2304Department of Urology, University of Florence, Florence, Italy
| | - Katia Odorizzi
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126 Verona, Italy
| | | | - Daniele Amparore
- grid.7605.40000 0001 2336 6580School of Medicine, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Aliasger Shakir
- grid.42505.360000 0001 2156 6853Keck School of Medicine, Institute of Urology, University of Southern California, Los Angeles, CA USA
| | - Umberto Carbonara
- grid.7644.10000 0001 0120 3326Department of Urology, Aldo Moro University, Bari, Italy
| | - Andrea Panunzio
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126 Verona, Italy
| | - Federica Trovato
- grid.8158.40000 0004 1757 1969Department of Surgery, Urology Section, University of Catania, Catania, Italy
| | - Michele Catellani
- grid.15667.330000 0004 1757 0843Department of Urology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Letizia M. I. Janello
- grid.15667.330000 0004 1757 0843Department of Urology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Lorenzo Bianchi
- grid.6292.f0000 0004 1757 1758Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giacomo Novara
- grid.5608.b0000 0004 1757 3470Unit of Urology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Fabrizio Dal Moro
- grid.5608.b0000 0004 1757 3470Unit of Urology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Riccardo Schiavina
- grid.6292.f0000 0004 1757 1758Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Elisa De Lorenzis
- grid.4708.b0000 0004 1757 2822Department of Urology, Foundation IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Parma
- Department of Urology, Mantua Hospital, Mantua, Italy
| | - Sebastiano Cimino
- grid.8158.40000 0004 1757 1969Department of Surgery, Urology Section, University of Catania, Catania, Italy
| | - Ottavio De Cobelli
- grid.15667.330000 0004 1757 0843Department of Urology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Francesco Maiorino
- grid.513830.cUrology Unit, San Carlo di Nancy Hospital - GVM Care and Research, Rome, Italy
| | - Pierluigi Bove
- grid.513830.cUrology Unit, San Carlo di Nancy Hospital - GVM Care and Research, Rome, Italy
| | - Fabio Crocerossa
- grid.411489.10000 0001 2168 2547Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Francesco Cantiello
- grid.411489.10000 0001 2168 2547Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - David D’Andrea
- grid.22937.3d0000 0000 9259 8492Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Federica Di Cosmo
- grid.417011.20000 0004 1769 6825Department of Urology, “Vito Fazzi” Hospital, Lecce Piazza Filippo Muratore, 1, 73100 Lecce, Italy
| | - Francesco Porpiglia
- grid.7605.40000 0001 2336 6580School of Medicine, Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Pasquale Ditonno
- grid.7644.10000 0001 0120 3326Department of Urology, Aldo Moro University, Bari, Italy
| | - Emanuele Montanari
- grid.4708.b0000 0004 1757 2822Department of Urology, Foundation IRCCS Ca’ Granda-Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Francesco Soria
- grid.7605.40000 0001 2336 6580Division of Urology, Department of Surgical Sciences - Urology, Città della Salute e della Scienza di Torino - Molinette Hospital, University of Turin, Turin, Italy
| | - Paolo Gontero
- grid.7605.40000 0001 2336 6580Division of Urology, Department of Surgical Sciences - Urology, Città della Salute e della Scienza di Torino - Molinette Hospital, University of Turin, Turin, Italy
| | - Giovanni Liguori
- grid.5133.40000 0001 1941 4308Department of Urology, University of Trieste, Cattinara Hospital - ASUGI, Trieste, Italy
| | - Carlo Trombetta
- grid.5133.40000 0001 1941 4308Department of Urology, University of Trieste, Cattinara Hospital - ASUGI, Trieste, Italy
| | - Guglielmo Mantica
- grid.5606.50000 0001 2151 3065Department of Urology, Policlinico San Martino Hospital, University of Genova, Genoa, Italy
| | - Marco Borghesi
- grid.5606.50000 0001 2151 3065Department of Urology, Policlinico San Martino Hospital, University of Genova, Genoa, Italy
| | - Carlo Terrone
- grid.5606.50000 0001 2151 3065Department of Urology, Policlinico San Martino Hospital, University of Genova, Genoa, Italy
| | - Francesco Del Giudice
- grid.417007.5Department of Maternal-Infant and Urological Sciences, Sapienza/Policlinico Umberto I, Rome, Italy
| | - Alessandro Sciarra
- grid.417007.5Department of Maternal-Infant and Urological Sciences, Sapienza/Policlinico Umberto I, Rome, Italy
| | - Andrea Galosi
- grid.7010.60000 0001 1017 3210Department of Urology, University of Ancona, Ancona, Italy
| | - Marco Moschini
- grid.18887.3e0000000417581884Division of Oncology, Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Shahrokh F. Shariat
- grid.22937.3d0000 0000 9259 8492Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Marta Di Nicola
- grid.412451.70000 0001 2181 4941Department of Medical, Oral and Biotechnological Sciences, G. d’Annunzio University of Chieti, Chieti, Italy
| | - Andrea Minervini
- grid.8404.80000 0004 1757 2304Department of Urology, University of Florence, Florence, Italy
| | - Matteo Ferro
- grid.15667.330000 0004 1757 0843Department of Urology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Maria Angela Cerruto
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126 Verona, Italy
| | - Luigi Schips
- grid.412451.70000 0001 2181 4941Department of Urology, University of Chieti, Chieti, Italy
| | - Vincenzo Pagliarulo
- grid.417011.20000 0004 1769 6825Department of Urology, “Vito Fazzi” Hospital, Lecce Piazza Filippo Muratore, 1, 73100 Lecce, Italy
| | - Alessandro Antonelli
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Piazzale Stefani 1, 37126 Verona, Italy
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Crocerossa F, Carbonara U, Parekh J, Urdaneta A, Weprin S, Damiano R, Grob MB, Hampton LJ, Paul A, Autorino R, Cantiello F. PSA and PSA Kinetics as Predictors for 18F-Fluciclovine PET/CT Positivity in Biochemically Recurrent Prostate Cancer. Urol Int 2021; 106:920-927. [PMID: 34933313 DOI: 10.1159/000520684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/13/2021] [Accepted: 10/24/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION 18F-Fluciclovine PET/CT is one of the imaging techniques currently employed to restage prostate cancer (PCa). Due to the conflicting results reported in the literature, it is not yet known at what PSA threshold 18F-fluciclovine PET/CT could reliably demonstrate the presence of recurring disease. We explored the association between 18F-fluciclovine PET/CT positivity and prescan PSA, PSA doubling time, and PSA velocity in patients with biochemical recurrence (BCR) of PCa after curative-intent treatment. METHODS Data from 59 patients who underwent 18F-fluciclovine PET/CT for BCR after radical prostatectomy or radiotherapy were retrieved from a single institution database. Patients already undergone salvage treatments at the time of PET/CT, with newly diagnosed PCa or with initial diagnosis of metastatic PCa were excluded. A 2-sided independent samples Bayesian t test and Bayesian Mann-Whitney U test were used to assess the association between PET/CT and prescan PSA, PSA doubling time, and PSA velocity. RESULTS Evidence for no difference between PET/CT-positive and -negative patients for log-transformed PSA was found (BF01 3.61, % error: 0.01). Robustness check and sequential analysis showed stability across a wide range of prior distribution specifications. The hypothesis of no difference in terms of PSA-dt and for PSA-vel between groups was found to be more likely compared to the alternative hypothesis (BF01 of 3.44 and 3.48, respectively). CONCLUSION PSA and PSA kinetics are unlikely to be associated with 18F-fluciclovine PET/CT positivity in patients with BCR, and none of these serum biomarkers might be used as single predictors of PET/CT detection. Larger studies might be needed to evaluate the role of different predictors.
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Affiliation(s)
- Fabio Crocerossa
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Umberto Carbonara
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Jayashree Parekh
- Department of Radiology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Alfredo Urdaneta
- Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Samuel Weprin
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Mayer B Grob
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Lance J Hampton
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Asit Paul
- Division of Hematology, Department of Internal Medicine, Oncology & Palliative Care, Richmond, Virginia, USA
| | - Riccardo Autorino
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Carbonara U, Crocerossa F, Autorino R. NIRF guided robot-assisted diverticulectomy and ureteral reimplantation for bladder cancer within Hutch diverticulum. Cent European J Urol 2021; 74:471. [PMID: 34729241 PMCID: PMC8552941 DOI: 10.5173/ceju.2021.0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 08/27/2021] [Accepted: 04/08/2021] [Indexed: 12/05/2022] Open
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33
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Carbonara U, Srinath M, Crocerossa F, Ferro M, Cantiello F, Lucarelli G, Porpiglia F, Battaglia M, Ditonno P, Autorino R. Robot-assisted radical prostatectomy versus standard laparoscopic radical prostatectomy: an evidence-based analysis of comparative outcomes. World J Urol 2021; 39:3721-3732. [PMID: 33843016 DOI: 10.1007/s00345-021-03687-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 10/20/2020] [Accepted: 03/26/2021] [Indexed: 02/07/2023] Open
Abstract
PURPOSE To provide a systematic analysis of the comparative outcomes of robot-assisted radical prostatectomy (RARP) versus laparoscopic radical prostatectomy (LRP) in the treatment of prostate cancer based on the best currently available evidence. METHODS An independent systematic review of the literature was performed up to February 2021, using MEDLINE®, EMBASE®, and Web of Science® databases. Preferred reporting items for systematic review and meta-analysis (PRISMA) recommendations were followed to design search strategies, selection criteria, and evidence reports. The quality of the included studies was determined using the Newcastle-Ottawa scale for non-randomized controlled trials. Demographics and clinical characteristics, surgical, pathological, and functional outcomes were collected. RESULTS Twenty-six studies were identified. Only 16 "high-quality" (RCTs and Newcastle-Ottawa scale 8-9) studies were included in the meta-analysis. Among the 13,752 patients included, 6135 (44.6%) and 7617 (55.4%) were RARP and LRP, respectively. There was no difference between groups in terms of demographics and clinical characteristics. Overall and major complication (Clavien-Dindo ≥ III) rates were similar in LRP than RARP group. The biochemical recurrence (BCR) rate at 12months was significantly lower for RARP (OR: 0.52; 95% CI 0.43-0.63; p < 0.00001). RARP reported lower urinary incontinence rate at 12months (OR: 0.38; 95% CI 0.18-0.8; p = 0.01). The erectile function recovery rate at 12months was higher for RARP (OR: 2.16; 95% CI 1.23-3.78; p = 0.007). CONCLUSION Current evidence shows that RARP offers favorable outcomes compared with LRP, including higher potency and continence rates, and less likelihood of BCR. An assessment of longer-term outcomes is lacking, and higher cost remains a concern of robotic versus laparoscopic prostate cancer surgery.
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Affiliation(s)
- Umberto Carbonara
- Division of Urology, VCU Health, Richmond, VA, 23298-0118, USA.,Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Maya Srinath
- Division of Urology, VCU Health, Richmond, VA, 23298-0118, USA
| | - Fabio Crocerossa
- Division of Urology, VCU Health, Richmond, VA, 23298-0118, USA.,Department of Urology, Magna Graecia University, Catanzaro, Italy
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology, IRCCS, Milan, Italy
| | | | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Francesco Porpiglia
- Department of Urology, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Michele Battaglia
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy.,Urology Unit, National Cancer Institute IRCCS, "Giovanni Paolo II", Bari, Italy
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34
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Crocerossa F, Carbonara U, Simone G, Minervini A, Larcher A, Bagalà L, Sicoli F, Cantiello F, Damiano R, Porpiglia F, Hampton L, Veccia A, Autorino R. EGFR decline at 1 year after minimally invasive partial nephrectomy: a multi-model comparison of predictors. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00756-4] [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] Open
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35
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Carbonara U, Capitanio U, Crocerossa F, Montorsi F, Ditonno P, Porpiglia F, Autorino R. Retroperitoneal vs. transepritoneal robotic partial nephrectomy for postero-lateral renal masses: an international multicenter analysis. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)00952-6] [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: 11/25/2022] Open
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36
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Carbonara U, Ditonno P, Crocerossa F, Montorsi F, Jhiad K, Autorino R. Comparison of robot-assisted partial nephrectomy and percutaneous ablation for cT1 renal masses: a multicenter analysis. EUR UROL SUPPL 2021. [DOI: 10.1016/s2666-1683(21)01005-3] [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: 11/30/2022] Open
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37
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Crocerossa F, Carbonara U, Cantiello F, Marchioni M, Ditonno P, Mir MC, Porpiglia F, Derweesh I, Hampton LJ, Damiano R, Autorino R. Robot-assisted Radical Nephrectomy: A Systematic Review and Meta-analysis of Comparative Studies. Eur Urol 2021; 80:428-439. [DOI: 10.1016/j.eururo.2020.10.034] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/23/2020] [Indexed: 12/21/2022]
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38
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Manfredi C, Arcaniolo D, Spatafora P, Crocerossa F, Fusco F, Verze P, Fiori C, Damiano R, Cindolo L, DE Sio M, Otero JR. Emerging minimally invasive transurethral treatments for benign prostatic hyperplasia: a systematic review with meta-analysis of functional outcomes and description of complications. Minerva Urol Nephrol 2021; 74:389-399. [PMID: 34308611 DOI: 10.23736/s2724-6051.21.04530-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Several minimally invasive surgical procedures have been proposed as alternative therapies for benign prostatic hyperplasia (BPH). The present systematic review aimed to describe the functional outcomes and complications of emerging minimally invasive transurethral treatments for BPH. EVIDENCE ACQUISITION A comprehensive bibliographic search on the MEDLINE and Cochrane Library databases was conducted. No chronological restriction was applied. Retrospective and prospective primary studies were included. A meta-analysis of IPSS, IPSS-QoL, Qmax, and PVR was performed. Data on adverse events were presented narratively. EVIDENCE SYNTHESIS A total of 18 studies were included. Thirteen papers were eligible for the meta-analysis. iTIND, Rezūm, and Aquablation were associated with a significant improvement in IPSS (p<0.001), IPSS-QoL (p<0.001), and Qmax (p<0.001) compared to baseline. A significant reduction of PVR from baseline was found with Rezūm (p<0.001) and Aquablation (p<0.001) but not iTIND (p=0.22). A significant difference in IPSS, IPSS-QoL, and Qmax was shown in favor of Aquablation compared to Rezūm and iTIND (p<0.001). Rezūm and iTIND were mainly associated with mild to moderate adverse effects. Hematuria or bleeding was reported in all studies regarding Aquablation (0.8%-26%), the need for transfusion or intervention for bleeding varied between 1.8% and 9%. CONCLUSIONS Aquablation, Rezūm, and iTIND significantly improve urinary functional outcomes compared to baseline; however, Aquablation would seem to lead to better functional results compared to the other procedures. Rezūm and iTIND appear to have an excellent safety profile, while Aquablation would seem to expose patients to a nonnegligible risk of bleeding.
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Affiliation(s)
- Celeste Manfredi
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy -
| | - Davide Arcaniolo
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Pietro Spatafora
- Department of Minimally Invasive and Robotic Urologic Surgery and Kidney Transplantation, Careggi Hospital, University of Florence, Florence, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Ferdinando Fusco
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Paolo Verze
- Department of Medicine, Surgery, Dentistry Scuola Medica Salernitana, University of, Salerno, Salerno, Italy
| | - Cristian Fiori
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Luca Cindolo
- Department of Urology, Villa Stuart Private Hospital, Rome, Italy
| | - Marco DE Sio
- Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Javier R Otero
- Department of Urology, Hospital Universitario 12 Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Unit of Urology, HM Hospitales, Montepríncipe, Puerta del Sur, Sanchinarro, Madrid, Spain
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39
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Ferro M, Lucarelli G, de Cobelli O, Dolce P, Terracciano D, Musi G, Porreca A, Busetto GM, Del Giudice F, Soria F, Gontero P, Cantiello F, Damiano R, Crocerossa F, Abu Farhan AR, Autorino R, Vartolomei MD, Marchioni M, Mari A, Minervini A, Longo N, Celentano G, Chiancone F, Perdonà S, Del Prete P, Ditonno P, Battaglia M, Zamboni S, Antonelli A, Greco F, Russo GI, Hurle R, Crisan N, Manfredi M, Porpiglia F, Ribera D, De Placido P, Facchini S, Scafuri L, Verde A, Di Lorenzo G, Cosimato V, Luciano A, Caputo VF, Crocetto F, Buonerba C. A risk-group classification model in patients with bladder cancer under neoadjuvant cisplatin-based combination chemotherapy. Future Oncol 2021; 17:3987-3994. [PMID: 34278815 DOI: 10.2217/fon-2020-1298] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The objective of the current research was to explore the potential prognostic value of readily available clinical and pathologic variables in bladder cancer. The novel association found between cholesterol levels and prognosis may provide the rationale for exploring novel treatments. Patients included had histologically confirmed urothelial bladder cancer and were treated with at least 3 cycles of cisplatin-based neoadjuvant chemotherapy before radical cystectomy with lymphadenectomy. A total of 245 patients at low, intermediate and high risk, presenting with 0-1, 2 or 3-4 risk factors, including positive lymph nodes, Hb <12.8, NLR ≥2.7 and cholesterol levels ≥199, were included. Five-year cancer-specific survival rate was 0.67, 0.78 and 0.94 at high, intermediate and low risk, respectively. Total cholesterol levels at the time of cystectomy may represent a commonly assessable prognostic factor and may be incorporated in a clinically meaningful risk-group classification model.
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Affiliation(s)
- Matteo Ferro
- Division of Urology, European Institute of Oncology, IRCCS, Milan 80131, Italy
| | | | - Ottavio de Cobelli
- Division of Urology, European Institute of Oncology, IRCCS, Milan 80131, Italy
| | - Pasquale Dolce
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, Naples 80131, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University Federico II, Naples, Italy
| | - Gennaro Musi
- Division of Urology, European Institute of Oncology, IRCCS, Milan 80131, Italy
| | - Angelo Porreca
- Department of Urology, Abano Terme Hospital, Padua 35031, Italy
| | | | | | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin 10121, Italy
| | - Paolo Gontero
- Division of Urology, Department of Surgical Sciences, San Giovanni Battista Hospital, University of Studies of Torino, Turin 10121, Italy
| | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro 88100, Italy
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro 88100, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro 88100, Italy
| | | | - Riccardo Autorino
- Division of Urology, VCU Health System, Virginia Commonwealth University, Richmond, VA 23219, USA
| | - Mihai Dorin Vartolomei
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Währinger Gürtel 18-20, Vienna 1090, Austria.,Department of Cell & Molecular Biology, University of Medicine, Pharmacy, Sciences & Technology, Targu Mures 540139, Romania
| | - Michele Marchioni
- Department of Medical, Oral & Biotechnological Sciences, G. d'Annunzio University of Chieti, Chieti, Italy
| | - Andrea Mari
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Andrea Minervini
- Department of Urology, University of Florence, Careggi Hospital, Florence, Italy
| | - Nicola Longo
- Department of Neurosciences, Human Reproduction & Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Giuseppe Celentano
- Department of Neurosciences, Human Reproduction & Odontostomatology, University of Naples Federico II, Naples, Italy
| | | | - Sisto Perdonà
- Division of Urology, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale," Naples, Italy
| | - Paola Del Prete
- Scientific Directorate, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale," Naples, Italy
| | - Pasquale Ditonno
- Department of Emergency & Organ Transplantation-Urology, Andrology & Kidney Transplantation Unit, University of Bari, Bari 70124, Italy
| | - Michele Battaglia
- Department of Emergency & Organ Transplantation-Urology, Andrology & Kidney Transplantation Unit, University of Bari, Bari 70124, Italy
| | - Stefania Zamboni
- Department of Urology, Spedali Civili di Brescia, Piazzale Spedali Civili 1, Brescia, Italy
| | - Alessandro Antonelli
- Department of Urology, Spedali Civili di Brescia, Piazzale Spedali Civili 1, Brescia, Italy.,Department of Urology, University of Verona, Verona, Italy
| | | | | | - Rodolfo Hurle
- Department of Urology, Humanitas Hospital, Milan, Italy
| | - Nicolae Crisan
- Department of Urology, University of Medicine & Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania
| | - Matteo Manfredi
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Turin, Italy
| | - Dario Ribera
- Department of Clinical Medicine & Surgery, University Federico II of Naples, Via Pansini 5, Naples 80131, Italy
| | - Pietro De Placido
- Department of Clinical Medicine & Surgery, University Federico II of Naples, Via Pansini 5, Naples 80131, Italy
| | - Sergio Facchini
- Medical Oncology, Department of Precision Medicine, School of Medicine, "Luigi Vanvitelli" University of Campania, Naples 80131, Italy
| | - Luca Scafuri
- Department of Clinical Medicine & Surgery, University Federico II of Naples, Via Pansini 5, Naples 80131, Italy
| | - Antonio Verde
- Department of Clinical Medicine & Surgery, University Federico II of Naples, Via Pansini 5, Naples 80131, Italy
| | - Giuseppe Di Lorenzo
- Oncology Unit, Andrea Tortora Hospital, ASL Salerno, Pagani, Italy.,Vincenzo Tiberio, Department of Medicine & Health Sciences, University of Molise, Campobasso, Italy
| | - Vincenzo Cosimato
- Division of Onco-hematology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Angelo Luciano
- Department of Clinical Medicine & Surgery, University Federico II of Naples, Via Pansini 5, Naples 80131, Italy
| | - Vincenzo Francesco Caputo
- Department of Neurosciences, Human Reproduction & Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Felice Crocetto
- Department of Neurosciences, Human Reproduction & Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Carlo Buonerba
- Regional Reference Center for Rare Tumors, Department of Oncology & Hematology, AOU Federico II of Naples, Naples 80131, Italy.,Centro di Referenza Nazionale per l'Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Naples, Italy
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40
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Weprin S, Crocerossa F, Meyer D, Maddra K, Valancy D, Osardu R, Kang HS, Moore RH, Carbonara U, J Kim F, Autorino R. Risk factors and preventive strategies for unintentionally retained surgical sharps: a systematic review. Patient Saf Surg 2021; 15:24. [PMID: 34253246 PMCID: PMC8276389 DOI: 10.1186/s13037-021-00297-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/13/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A retained surgical item (RSI) is defined as a never-event and can have drastic consequences on patient, provider, and hospital. However, despite increased efforts, RSI events remain the number one sentinel event each year. Hard foreign bodies (e.g. surgical sharps) have experienced a relative increase in total RSI events over the past decade. Despite this, there is a lack of literature directed towards this category of RSI event. Here we provide a systematic review that focuses on hard RSIs and their unique challenges, impact, and strategies for prevention and management. METHODS Multiple systematic reviews on hard RSI events were performed and reported using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the methodological quality of systematic reviews) guidelines. Database searches were limited to the last 10 years and included surgical "sharps," a term encompassing needles, blades, instruments, wires, and fragments. Separate systematic review was performed for each subset of "sharps". Reviewers applied reciprocal synthesis and refutational synthesis to summarize the evidence and create a qualitative overview. RESULTS Increased vigilance and improved counting are not enough to eliminate hard RSI events. The accurate reporting of all RSI events and near miss events is a critical step in determining ways to prevent RSI events. The implementation of new technologies, such as barcode or RFID labelling, has been shown to improve patient safety, patient outcomes, and to reduce costs associated with retained soft items, while magnetic retrieval devices, sharp detectors and computer-assisted detection systems appear to be promising tools for increasing the success of metallic RSI recovery. CONCLUSION The entire healthcare system is negatively impacted by a RSI event. A proactive multimodal approach that focuses on improving team communication and institutional support system, standardizing reports and implementing new technologies is the most effective way to improve the management and prevention of RSI events.
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Affiliation(s)
- Samuel Weprin
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, 23298-0118, USA
| | - Fabio Crocerossa
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, 23298-0118, USA
- Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Dielle Meyer
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, 23298-0118, USA
| | - Kaitlyn Maddra
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, 23298-0118, USA
| | - David Valancy
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, 23298-0118, USA
| | - Reginald Osardu
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, 23298-0118, USA
| | - Hae Sung Kang
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, 23298-0118, USA
| | - Robert H Moore
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, 23298-0118, USA
| | - Umberto Carbonara
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, 23298-0118, USA
- Dept of Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Fernando J Kim
- Division of Urology Denver Health Medical Center and University of Colorado Anschutz Medical Center, Colorado, Denver, USA
| | - Riccardo Autorino
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, 23298-0118, USA.
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Carbonara U, Branche B, Cisu T, Crocerossa F, Guruli G, Grob MB, Roseman T, Hampton LJ, Autorino R. ROBOT-ASSISTED URETERAL REIMPLANTATION: A SINGLE CENTER COMPARATIVE STUDY. J Endourol 2021; 35:1504-1511. [PMID: 34098751 DOI: 10.1089/end.2021.0083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND To report a single-center experience with robot-assisted ureteral reimplantation (RAUR) and to compare its outcomes with those of open ureteral reimplantation (OUR). MATERIALS AND METHODS Patients who underwent RAUR or OUR for ureteral disease between 2016 and 2020 were identified. Data collected included baseline, pathological, perioperative and postoperative features. The RAUR outcomes were compared with those of OUR. RESULTS Overall, twenty-one (42.8%) patients underwent RAUR, and 28 (57.2%) underwent OUR. The two groups were similar in terms of baseline and pathological characteristics. There was a statistically significant difference in favor of RAUR for median operative time (216 vs. 317min, p=0.01) and median blood loss (35 vs. 175ml, p=0.001). No difference was observed in overall complication rate (33.3 vs. 46.4%, p=0.9), as well as major complications (Clavien-Dindo≥III grade) rate between RAUR and OUR groups. Median LOS was shorter for RAUR (2 vs. 6 days; p=0.001), as well as median catheterization time (16 vs. 28 days; p=0.005). CONCLUSIONS RAUR is a safe and effective minimally invasive surgical procedure for the management of mid to distal ureteral strictures. It can recapitulate the success rate of the gold standard OUR while offering a benefit in terms of lower surgical morbidity and faster postoperative recovery.
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Affiliation(s)
- Umberto Carbonara
- Virginia Commonwealth University Health System, 6887, Department of Urology, 11200 E BROAD ST, RICHMOND, Richmond, Virginia, United States, 23233.,Università degli Studi di Bari Aldo Moro, 9295, Department of Urology, Bari, Puglia, Italy;
| | | | - Theodore Cisu
- VCU Health, 6887, Richmond, Virginia, United States;
| | - Fabio Crocerossa
- Virginia Commonwealth University Health System, 6887, Department of Urology, 1200 E Broad St., Richmond, Virginia, United States, 23298;
| | - Georgi Guruli
- VCU Health, 6887, Richmond, Virginia, United States;
| | - Mayer B Grob
- VCU Health, 6887, Richmond, Virginia, United States;
| | - Tyler Roseman
- VCU Health, 6887, Richmond, Virginia, United States;
| | | | - Riccardo Autorino
- Virginia Commonwealth University Health System, 6887, Surgery (Urology), 1200 East Broad st, Richmond, Virginia, United States, 23298;
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Carbonara U, Capitanio U, Eun D, Derweesh I, Celia A, Fiori C, Larcher A, Crocerossa F, Hampton L, Montorsi F, Porpiglia F, Autorino R. Retroperitoneal vs. transperitoneal robotic partial nephrectomy for postero-lateral renal masses: An international multicenter analysis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00953-2] [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: 10/20/2022]
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43
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Carbonara U, Beksac A, Larcher A, Basile G, Crocerossa F, Celia A, Montorsi F, Derweesh I, Capitanio U, Kaouk J, Autorino R. Comparison of robot-assisted partial nephrectomy and percutaneous ablation for ct1 renal masses: Mid term outcome analysis. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00943-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: 11/24/2022]
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44
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Carbonara U, Eun D, Derweesh I, Capitanio U, Celia A, Fiori C, Checcucci E, Amparore D, Lee J, Larcher A, Patel D, Meagher M, Crocerossa F, Veccia A, Hampton LJ, Montorsi F, Porpiglia F, Autorino R. Retroperitoneal versus transepritoneal robot-assisted partial nephrectomy for postero-lateral renal masses: an international multicenter analysis. World J Urol 2021; 39:4175-4182. [PMID: 34050813 DOI: 10.1007/s00345-021-03741-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/02/2021] [Accepted: 05/20/2021] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To assess the outcomes of retroperitoneal robot-assisted partial nephrectomy (r-RAPN) in a large cohort of patients with postero-lateral renal masses comparing to those of transperitoneal RAPN (t-RAPN). METHODS Patients with posterior (R.E.N.A.L. score grading P) or lateral (grading X) renal mass who underwent RAPN in six high-volume US and European centers were identified and stratified into two groups according to surgical approach: r-RAPN ("study group") and t-RAPN ("control group"). Baseline characteristics, intraoperative, and postoperative data were collected and compared. RESULTS Overall, 447 patients were identified for the analysis. 231 (51.7%) and 216 (48.3%) patients underwent r-RAPN and t-RAPN, respectively. Baseline characteristics were not statistically significantly different between the groups. r-RAPN group reported lower median operative time (140 vs. 170 min, p < 0.001). No difference was found in ischemia time, estimated blood loss, and intraoperative complications. Overall, 47 and 54 postoperative complications were observed in r-RAPN and t-RAPN groups, respectively (20.3 vs. 25.1%, p = 0.9). 1 and 2 patients reported major complications (Clavien-Dindo ≥ III grade) in the retroperitoneal and transperitoneal groups (0.4 vs. 0.9%, p = 0.9). There was no difference in hospital re-admission rate, median length of stay, and PSM rate. Trifecta criteria were achieved in 90.3 and 89.2% of r-RAPN and t-RAPN, respectively (p = 0.7). CONCLUSION r-RAPN and t-RAPN offer similar postoperative, functional, and oncological outcomes for patients with postero-lateral renal tumors. Our analysis suggests an advantage for r-RAPN in terms of shorter operative time, whereas it does not confirm a difference in terms of length of stay, as suggested by previous reports.
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Affiliation(s)
- Umberto Carbonara
- Division of Urology, VCU Health, Richmond, VA, 23298-0118, USA.,Department of Urology, University of Bari, Bari, Italy
| | - Daniel Eun
- Department of Urology, Temple University, Philadelphia, PA, USA
| | | | - Umberto Capitanio
- Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy.,Division of Experimental Oncology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Milan, Italy
| | - Antonio Celia
- Department of Urology, San Bassiano Hospital, Bassano del Grappa, Vicenza, Italy
| | - Cristian Fiori
- Department of Urology, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Enrico Checcucci
- Department of Urology, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Daniele Amparore
- Department of Urology, San Luigi Hospital, University of Turin, Orbassano, Italy
| | - Jennifer Lee
- Department of Urology, Temple University, Philadelphia, PA, USA
| | - Alessandro Larcher
- Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy.,Division of Experimental Oncology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Milan, Italy
| | - Devin Patel
- Department of Urology, UCSD, San Diego, CA, USA
| | | | | | | | - Lance J Hampton
- Division of Urology, VCU Health, Richmond, VA, 23298-0118, USA
| | - Francesco Montorsi
- Unit of Urology, IRCCS Ospedale San Raffaele, Milan, Italy.,Division of Experimental Oncology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Milan, Italy
| | - Francesco Porpiglia
- Department of Urology, San Luigi Hospital, University of Turin, Orbassano, Italy
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45
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Ferro M, de Cobelli O, Musi G, Lucarelli G, Terracciano D, Pacella D, Muto T, Porreca A, Busetto GM, Del Giudice F, Soria F, Gontero P, Cantiello F, Damiano R, Crocerossa F, Farhan ARA, Autorino R, Vartolomei MD, Muto M, Marchioni M, Mari A, Scafuri L, Minervini A, Longo N, Chiancone F, Perdona S, De Placido P, Verde A, Catellani M, Luzzago S, Mistretta FA, Ditonno P, Caputo VF, Battaglia M, Zamboni S, Antonelli A, Greco F, Russo GI, Hurle R, Crisan N, Manfredi M, Porpiglia F, Di Lorenzo G, Crocetto F, Buonerba C. Three vs. Four Cycles of Neoadjuvant Chemotherapy for Localized Muscle Invasive Bladder Cancer Undergoing Radical Cystectomy: A Retrospective Multi-Institutional Analysis. Front Oncol 2021; 11:651745. [PMID: 34046347 PMCID: PMC8144638 DOI: 10.3389/fonc.2021.651745] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/02/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Three or four cycles of cisplatin-based chemotherapy is the standard neoadjuvant treatment prior to cystectomy in patients with muscle-invasive bladder cancer. Although NCCN guidelines recommend 4 cycles of cisplatin-gemcitabine, three cycles are also commonly administered in clinical practice. In this multicenter retrospective study, we assessed a large and homogenous cohort of patients with urothelial bladder cancer (UBC) treated with three or four cycles of neoadjuvant cisplatin-gemcitabine followed by radical cystectomy, in order to explore whether three vs. four cycles were associated with different outcomes. METHODS Patients with histologically confirmed muscle-invasive UBC included in this retrospective study had to be treated with either 3 (cohort A) or 4 (cohort B) cycles of cisplatin-gemcitabine as neoadjuvant therapy before undergoing radical cystectomy with lymphadenectomy. Outcomes including pathologic downstaging to non-muscle invasive disease, pathologic complete response (defined as absence of disease -ypT0), overall- and cancer-specific- survival as well as time to recurrence were compared between cohorts A vs. B. RESULTS A total of 219 patients treated at 14 different high-volume Institutions were included in this retrospective study. Patients who received 3 (cohort A) vs. 4 (cohort B) cycles of neoadjuvant cisplatin-gemcitabine were 160 (73,1%) vs. 59 (26,9%).At univariate analysis, the number of neoadjuvant cycles was not associated with either pathologic complete response, pathologic downstaging, time to recurrence, cancer specific, and overall survival. Of note, patients in cohort B vs. A showed a worse non-cancer specific overall survival at univariate analysis (HR= 2.53; 95 CI= 1.05 - 6.10; p=0.046), although this finding was not confirmed at multivariate analysis. CONCLUSIONS Our findings suggest that 3 cycles of cisplatin-gemcitabine may be equally effective, with less long-term toxicity, compared to 4 cycles in the neoadjuvant setting.
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Affiliation(s)
- Matteo Ferro
- Division of Urology of European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Ottavio de Cobelli
- Division of Urology of European Institute of Oncology (IEO), IRCCS, Milan, Italy
- Department of Oncology and Hematology Oncology, Faculty of Medicine and Surgery, University of Milan, Milan, Italy
| | - Gennaro Musi
- Division of Urology of European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Daniela Terracciano
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Tommaso Muto
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Angelo Porreca
- Oncological Urology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy
| | - Gian Maria Busetto
- Department of Urology and Renal Transplantation, University of Foggia Policlinico Riuniti of Foggia, Foggia, Italy
| | | | - Francesco Soria
- Division of Urology, Department of Surgical Sciences, AOU Cittá della Salute e della Scienza, Torino School of Medicine, Turin, Italy
| | - Paolo Gontero
- Division of Urology, Department of Surgical Sciences, AOU Cittá della Salute e della Scienza, Torino School of Medicine, Turin, Italy
| | - Francesco Cantiello
- Department of Urology, University of Catanzaro, UNIVERSITÁ “MAGNA GRÆCIA” di Catanzaro, Catanzaro, Italy
| | - Rocco Damiano
- Department of Urology, University of Catanzaro, UNIVERSITÁ “MAGNA GRÆCIA” di Catanzaro, Catanzaro, Italy
| | - Fabio Crocerossa
- Department of Urology, University of Catanzaro, UNIVERSITÁ “MAGNA GRÆCIA” di Catanzaro, Catanzaro, Italy
| | - Abdal Rahman Abu Farhan
- Department of Urology, University of Catanzaro, UNIVERSITÁ “MAGNA GRÆCIA” di Catanzaro, Catanzaro, Italy
| | - Riccardo Autorino
- Division of Urology, Virginia Commonwealth University Health System, Richmond, VA, United States
| | - Mihai Dorin Vartolomei
- Department of Urology, Vienna General Hospital, Vienna, Austria
- Department of Cell and Molecular Biology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureş, Tirgu Mures, Romania
| | - Matteo Muto
- Department of Hematology, Oncology and Radiotherapy Azienda ospedaliera San Giuseppe Moscati, Avellino, Avelino, Italy
| | - Michele Marchioni
- Department of Urology, G. D’Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Andrea Mari
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Luca Scafuri
- Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Andrea Minervini
- Department of Experimental and Clinical Medicine, Unit of Oncologic Minimally-Invasive Urology and Andrology, University of Florence, Careggi University Hospital, Florence, Italy
| | - Nicola Longo
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | | | - Sisto Perdona
- Division of Urology, Istituto Nazionale Tumori Fondazione G. Pascale (IRCCS), Naples, Italy
| | - Pietro De Placido
- Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Antonio Verde
- Department of Clinical Medicine and Surgery, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Michele Catellani
- Division of Urology of European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Stefano Luzzago
- Division of Urology of European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | | | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Vincenzo Francesco Caputo
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Michele Battaglia
- Department of Emergency and Organ Transplantation, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Stefania Zamboni
- Department of Urology, Civil Hospital of Brescia, Brescia, Italy
| | - Alessandro Antonelli
- Department of Urology, Civil Hospital of Brescia, Brescia, Italy
- Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata Verona - Polo Chirurgico Confortini - Borgo Trento, Verona, Italy
| | - Francesco Greco
- Department of Urology, Humanitas Gavazzeni, IRRCS, Bergamo, Italy
| | | | - Rodolfo Hurle
- Department of Urology, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Nicolae Crisan
- Department of Urology, Iuliu Hațieganu University of Medicine and Pharmacy, Ciuj Napoca, Romania
| | - Matteo Manfredi
- Urology Unit - Department of Oncology, School of Medicine, University of Turin, Turin, Italy
| | - Francesco Porpiglia
- Urology Unit - Department of Oncology, School of Medicine, University of Turin, Turin, Italy
| | - Giuseppe Di Lorenzo
- Department of Urology, Humanitas Research Hospital Milano, Milan, Italy
- Department of Medicine and Health Science, University of Molise, Campobasso, Italy
| | - Felice Crocetto
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Naples, Italy
| | - Carlo Buonerba
- Rare Tumor Reference Center, Federico II University Hospital, Naples, Italy
- Centro di Referenza Nazionale per l’Analisi e Studio di Correlazione tra Ambiente, Animale e Uomo, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Italy
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Carbonara U, Simone G, Minervini A, Sundaram CP, Larcher A, Lee J, Checcucci E, Fiori C, Patel D, Meagher M, Crocerossa F, Veccia A, Hampton LJ, Ditonno P, Battaglia M, Brassetti A, Bove A, Mari A, Campi R, Carini M, Sulek J, Montorsi F, Capitanio U, Eun D, Porpiglia F, Derweesh I, Autorino R. Outcomes of robot-assisted partial nephrectomy for completely endophytic renal tumors: A multicenter analysis. Eur J Surg Oncol 2021; 47:1179-1186. [DOI: 10.1016/j.ejso.2020.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/30/2020] [Accepted: 08/10/2020] [Indexed: 10/23/2022] Open
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47
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Cantiello F, Fimognari D, Di Mauro M, Crocerossa F, Carbonara U, Ferro M, De Cobelli O, Lucarelli G, De Nunzio C, Morgia G, Damiano R, Autorino R, Porpiglia F, Russo GI. Mechanical and Ablative Minimally Invasive Techniques for Male LUTS due to Benign Prostatic Obstruction: A Systematic Review according to BPH-6 Evaluation. Urol Int 2021; 105:858-868. [PMID: 33849045 DOI: 10.1159/000514438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/26/2020] [Accepted: 12/22/2020] [Indexed: 11/19/2022]
Abstract
The treatment of male lower urinary tract symptoms (LUTS) due to benign prostatic obstruction represents one of the major interesting aspects in urological clinical practice. Although transurethral resection of the prostate is still considered the surgical gold standard for treatment of benign prostatic hyperplasia with prostate volume <80 mL, various minimally invasive surgical treatments (MITs) have been developed to overcome the limitations of the "conventional" surgery. To date, there are no validated tools to evaluate the surgical outcomes of MITs; however, in the past, BPH-6 has been used for this purpose. In this systematic review, we evaluated the efficacy and safety of MITs according to BPH-6 score system. We focused our attention on MITs based on mechanical devices (prostatic urethral lift and the temporary implantable nitinol device) and techniques for prostate ablation (image guided robotic waterjet ablation and convective water vapor energy ablation). Evidence shows that MITs are capable of leading to an improvement in LUTS without having an overwhelming impact on complications and are a valid alternative to other treatments in patients who wish to preserve their sexual function or in case of inapplicability of conventional surgery. However, comparative studies between these techniques are still missing.
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Affiliation(s)
- Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Deborah Fimognari
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Marina Di Mauro
- Department of Urology, University of Catania, Catania, Italy
| | - Fabio Crocerossa
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy.,Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Umberto Carbonara
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA.,Department of Urology, Andrology and Kidney Transplantation, University of Bari, Bari, Italy
| | - Matteo Ferro
- Department of Urology, European Institute of Oncology, Milan, Italy
| | | | - Giuseppe Lucarelli
- Department of Urology, Andrology and Kidney Transplantation, University of Bari, Bari, Italy
| | | | - Giuseppe Morgia
- Department of Urology, University of Catania, Catania, Italy
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Riccardo Autorino
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Francesco Porpiglia
- Division of Urology, Department of Oncology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
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Weprin SA, Meyer D, Li R, Carbonara U, Crocerossa F, Kim FJ, Autorino R, Speich JE, Klausner AP. Incidence and OR team awareness of "near-miss" and retained surgical sharps: a national survey on United States operating rooms. Patient Saf Surg 2021; 15:14. [PMID: 33812376 PMCID: PMC8019169 DOI: 10.1186/s13037-021-00287-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/09/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION A retained surgical sharp (RSS) is a never event and defined as a lost sharp (needle, blade, instrument, guidewire, metal fragment) that is not recovered prior to the patient leaving the operating room. A "near-miss" sharp (NMS) is an intraoperative event where there is a lost surgical sharp that is recovered prior to the patient leaving the operating room. With underreporting of such incidents, it is unrealistic to expect aggressive development of new prevention and detection strategies. Moreover, awareness about the issue of "near-miss" or retained surgical sharps remains limited. The aim of this large-scale national survey-based study was to estimate the incidence of these events and to identify the challenges surrounding the use of surgical sharps in daily practice. METHODS We hypothesized that there was a larger number of RSS and NMS events than what was being reported. We survived the different OR team members to determine if there would be discordance in reported incidence between groups and to also evaluate for user bias. An electronic survey was distributed to OR staff between December 2019 and April 2020. Respondents included those practicing within the United States from both private and academic institutions. Participants were initially obtained by designating three points of contact who identified participants at their respective academic institutions and while attending specialty specific medical conferences. Together, these efforts totaled 197 responses. To increase the number of respondents, additional emails were sent to online member registries. Approximately 2650 emails were sent resulting in an additional 250 responses (9.4% response rate). No follow up reminders were sent. In total, there were 447 survey responses, in which 411 were used for further analysis. Thirty-six responses were removed due to incomplete respondent data. Those who did not meet the definition of one of the three categories of respondents were also excluded. The 411 were then categorized by group to include 94 (22.9%) from anesthesiologist, 132 (32.1%) from resident/fellow/attending surgeon and 185 (45%) from surgical nurse and technologist. SURVEY The survey was anonymous. Participants were asked to answer three demographic questions as well as eight questions related to their personal perception of NMS and RSS (Fig. 1). Demographic questions were asked with care to ensure no identifiable information was obtained and therefore unable to be traced back to a specific respondent or institution. Perception questions 4-6 and 11 were designed to understand the incidence of various sharp events (e.g. lost, retained, miscounted). Questions 7 and 10 were dedicated to understanding time spent managing sharps and questions 8 and 9 were dedicated to understanding the use x-ray and its effectiveness. RESULTS Overall, most of each respondent group reported 1-5 lost sharp events over the last year. Roughly 20% of surgeons believed they never had a miscounted sharp over the last year, where only 5.3% of anesthesiologist reported the same (p = 0.002). Each group agreed that roughly 4 lost events occur every 1000 surgeries, but a significant difference was found between the three groups regarding the number of lost sharps not recovered per 10,000 surgeries with anesthesiologist, surgeon and nurse/technologist groups estimating 2.37, 2.56 and 2.94 respectively (p = 0.001). All groups noted x-ray to offer poor effectiveness at 26-50% with 31-40 min added for each time x-ray was used. More than half (56.8%) of surgeons reported using x-ray 100% of the time when managing a lost sharp whereas anesthesiologists and nurses/technologists believe it is closer to 1/3 of the time. An average of 21-30 min is spent managing each NMS, making a lost sharp event result in up to 70 min of added OR time. CONCLUSIONS "Near-miss" and RSS are more prevalent than what is reported in current literature. Surgeons perceive a higher rate of success in retrieving the RSS when compared to anesthesiologists and OR nurses/technologists. We recognize several challenges surrounding "near-miss" and never events as contributing factors to their underreported nature and the higher degree of surgeon recall bias associated with these events. Additionally, we highlight that current methods for prevention are costly in time and resources without improvement in patient safety. As NMS and RSS have significant health system implications, a strong understanding of these implications is important as we strive to improve patient safety.
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Affiliation(s)
- Samuel A Weprin
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, USA
| | - Dielle Meyer
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, USA
| | - Rui Li
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, USA
| | - Umberto Carbonara
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, USA
| | - Fabio Crocerossa
- Division of Urology, Department of Surgery, VCU Health, Richmond, VA, USA
| | - Fernando J Kim
- Division of Urology Denver Health Medical Center and University of Colorado Anschutz Medical Campus, Denver, USA.
| | - Riccardo Autorino
- Division of Urology Denver Health Medical Center and University of Colorado Anschutz Medical Campus, Denver, USA
| | - John E Speich
- Division of Urology Denver Health Medical Center and University of Colorado Anschutz Medical Campus, Denver, USA
| | - Adam P Klausner
- Division of Urology Denver Health Medical Center and University of Colorado Anschutz Medical Campus, Denver, USA
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Branche B, Crocerossa F, Carbonara U, Klausner AP, Roseman JT, Hampton LJ, Autorino R. Management of Bladder Neck Contracture in the Age of Robotic Prostatectomy: An Evidence-based Guide. Eur Urol Focus 2021; 8:297-301. [PMID: 33531288 DOI: 10.1016/j.euf.2021.01.007] [Citation(s) in RCA: 6] [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: 10/08/2020] [Revised: 11/16/2020] [Accepted: 01/08/2021] [Indexed: 11/30/2022]
Abstract
The incidence of bladder neck contracture (BNC), or postprostatectomy vesicourethral anastomosis, has declined since the advent of robotic surgery. However, men with peripheral vascular comorbidities, among other factors, still have a high risk of developing this complication after any surgery that involves manipulation of the prostate. The best strategy for BNC management remains uncertain because of inconsistency in success for different approaches across studies. We reviewed the available evidence on BNC, including the results for endoscopic treatments, scar modulation therapies, and open and robotic bladder neck reconstruction. On the basis of these data, we propose a management flowchart. Patient baseline status and subjective goals and preferences remain crucial in management choices. PATIENT SUMMARY: Contracture of the bladder neck can occur as a complication after surgery to the prostate. We reviewed the evidence for various treatment approaches and propose a flowchart for management of this condition.
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Affiliation(s)
- Brandee Branche
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Fabio Crocerossa
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA; Division of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Umberto Carbonara
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA; Department of Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy
| | - Adam P Klausner
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - John T Roseman
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Lance J Hampton
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Riccardo Autorino
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.
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Falagario UG, Veccia A, Cormio L, Simeone C, Carbonara U, Crocerossa F, Antonelli A, Porpiglia F, Carrieri G, Autorino R. Nomogram predicting 30-day mortality after nephrectomy in the contemporary era: Results from the SEER database. Int J Urol 2020; 28:309-314. [PMID: 33319434 DOI: 10.1111/iju.14461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 05/21/2020] [Accepted: 11/09/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES To assess contemporary 30-day mortality rates after partial and radical nephrectomy in USA, and to develop a predictive model of 30-day mortality. METHODS We relied on the National Cancer Institute Surveillance, Epidemiology and End Results database. A multivariable logistic regression analysis was fitted to predict 30-day mortality. A nomogram was built based on the coefficients of the logit function. Internal validation was carried out using the leave-one-out cross-validation. Calibration was graphically investigated. RESULTS A total of 102 146 patients who underwent partial nephrectomy (n = 36 425; 35.7%) or radical nephrectomy (n = 65 721; 64.3%) between 2005 and 2015 were included in the analysis. The median age at diagnosis was 62 years. A total of 11 921 (11.7%) patients were African American. The clinical stage was T1-T2 in 79 452 (77.8%), T3 in 16 141 (15.8%) and T4/T1-4-M1 in 6553 (6.4%) patients. Overall, 497 deaths occurred during the initial 30 days after nephrectomy (0.49% 30-day mortality rate). Stratified by type of surgery, the 30-day mortality rate was 0.16% for partial nephrectomy and 0.67% for radical nephrectomy. At univariate analyses, age, tumor size, stage and surgical procedure emerged as predictors of 30-day mortality (all P < 0.001). All of these covariates were included in the multivariable logistic regression model. The area under the curve after leave-one-out cross-validation was 0.808 (95% confidence interval 0.788-0.828), and the model showed good calibration in the range of predicted probability <10%. CONCLUSIONS Contemporary rates of 30-day mortality in patients undergoing radical or partial nephrectomy are very low. Age and tumor stage are key determinants of 30-day mortality. We present a predictive model that provides individual probabilities of 30-day mortality after nephrectomy, and it can be used for patient counseling prior surgery.
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Affiliation(s)
- Ugo Giovanni Falagario
- Division of Urology, Virginia Commonwealth University Health, Richmond, Virginia, USA.,Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Alessandro Veccia
- Division of Urology, Virginia Commonwealth University Health, Richmond, Virginia, USA.,Urology Unit, ASST Spedali Civili Hospital, Brescia, Italy.,Department of Medical and Surgical Specialties, Radiological Science, and Public Health, University of Brescia, Brescia, Italy
| | - Luigi Cormio
- Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Claudio Simeone
- Urology Unit, ASST Spedali Civili Hospital, Brescia, Italy.,Department of Medical and Surgical Specialties, Radiological Science, and Public Health, University of Brescia, Brescia, Italy
| | - Umberto Carbonara
- Division of Urology, Virginia Commonwealth University Health, Richmond, Virginia, USA
| | - Fabio Crocerossa
- Division of Urology, Virginia Commonwealth University Health, Richmond, Virginia, USA
| | | | | | - Giuseppe Carrieri
- Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Riccardo Autorino
- Division of Urology, Virginia Commonwealth University Health, Richmond, Virginia, USA
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