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Lai S, Pastore S, Piloni L, Mangiulli M, Esposito Y, Pierella F, Galani A, Pintus G, Mastroluca D, Shahabadi H, Ciccariello M, Salciccia S, Von Heland M. Chronic kidney disease and urological disorders: systematic use of uroflowmetry in nephropathic patients. Clin Kidney J 2019; 12:414-419. [PMID: 31198542 PMCID: PMC6543956 DOI: 10.1093/ckj/sfy085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 01/24/2018] [Indexed: 02/01/2023] Open
Abstract
Background Chronic kidney disease (CKD) is a highly prevalent condition. Urologic disorders are known causes of CKD, but often remain undiagnosed and underestimated also for their insidious onset and slow progression. We aimed to evaluate the prevalence of urological unrecognized diseases in CKD patients by uroflowmetry. Methods We enrolled consecutive stable CKD outpatients. The patients carried out two questionnaires, the International Prostate Symptom Score and Incontinence Questionnaire-Short Form, and they also underwent uroflowmetry, evaluating max flow rate (Qmax), voiding time and voided volume values. Results A total of 83 patients (43 males, mean age of 59.8 ± 13.3 years) were enrolled. Our study showed 28 males and 10 females with a significant reduction of Qmax (P < 0.001) while 21 females reported a significant increase of Qmax (P < 0.001) with a prevalence of 49.5% of functional urological disease. Moreover, we showed a significant association between Qmax and creatinine (P = 0.013), estimated glomerular filtration rate (P = 0.029) and voiding volume (P = 0.05). We have not shown significant associations with age (P = 0.215), body mass index (P = 0.793), systolic blood pressure (P = 0.642) or diastolic blood pressure (P = 0.305). Moreover, Pearson’s chi-squared test showed a significant association between Qmax altered with CKD (χ2 = 1.885, P = 0.170) and recurrent infection (χ2 = 8.886, P = 0.012), while we have not shown an association with proteinuria (χ2 = 0.484, P = 0.785), diabetes (χ2 = 0.334, P = 0.563) or hypertension (χ2 = 1.885, P = 0.170). Conclusions We showed an elevated prevalence of urological diseases in nephropathic patients; therefore, we suggest to include uroflowmetry in CKD patient assessment, considering the non-invasiveness, repeatability and low cost of examination. Uroflowmetry could be used to identify previously unrecognized urological diseases, which may prevent the onset of CKD or progression to end-stage renal disease and reduce the costs of management.
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Affiliation(s)
- Silvia Lai
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Serena Pastore
- Department of Obstetrical-Gynecological Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | - Leonardo Piloni
- Department of Obstetrical-Gynecological Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | - Marco Mangiulli
- Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, Rome, Italy
| | - Ylenia Esposito
- Department of Internal Medicine and Medical Specialities, Sapienza University of Rome, Rome, Italy
| | - Federico Pierella
- Department of Obstetrical-Gynecological Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | - Alessandro Galani
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Giovanni Pintus
- Department of Clinical Medicine, Sapienza University of Rome, Rome, Italy
| | - Daniela Mastroluca
- Nephrology and Dialysis Unit, Hospital ICOT Latina, Sapienza University of Rome, Rome, Italy
| | - Hossein Shahabadi
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Mauro Ciccariello
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy
| | - Stefano Salciccia
- Department of Obstetrical-Gynecological Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | - Magnus Von Heland
- Department of Obstetrical-Gynecological Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
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Sciarra A, Gentilucci A, Silvestri I, Salciccia S, Cattarino S, Scarpa S, Gatto A, Frantellizzi V, Von Heland M, Ricciuti GP, Del Giudice F, Maggi M. Androgen receptor variant 7 (AR-V7) in sequencing therapeutic agents for castratrion resistant prostate cancer: A critical review. Medicine (Baltimore) 2019; 98:e15608. [PMID: 31083254 PMCID: PMC6531263 DOI: 10.1097/md.0000000000015608] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND androgen receptor variant 7 (AR-V7) has been suggested as potential marker for treatment selection in men with metastatic castration-resistant prostate cancer (mCRPC). The aim of the present review is to critically analyze: frequency of the AR-V7 expression in mCRPC cases-impact of AR-V7 expression on abiraterone, enzalutamide, and taxane therapy. METHODS we searched in the Medline and Cochrane Library database from the literature of the past 10 years. We critically evaluated the level of evidence according to the European Association of Urology (EAU) guidelines. RESULTS 12 clinical trials were selected. The determination of AR-V7 in peripheral blood using circulating tumor cells mRNA seems to be the preferred method. At baseline, the mean percentage of cases with AR-V7 positivity was 18.3% (range 17.8%-28.8%). All data on mCRPC submitted to enzalutamide or abiraterone reported a significantly (P <.05) lower clinical progression-free survival (CPFS) and overall survival (OS) in AR-V7+ than AR-V7- cases (CPFS hazard ratio [HR]: 2.3; 95% CI 1.1-4.9; OS HR: 3.0; 95% CI 1.4-6.3). In mCRPC cases submitted to chemotherapies data are not homogeneous and some studies showed no association between CPFS or OS and AR-V7 status (OS HR 1.6; 95% CI 0.6-4.4; P = .40). CONCLUSIONS the suggestion is that taxane therapy is more efficacious than abiraterone or enzalutamide for men with AR-V7+ CRPC. On the contrary, clinical outcomes did not seem to differ significantly on the basis of the type of therapy used among AR-V7- cases.
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Affiliation(s)
- Alessandro Sciarra
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome
| | | | - Ida Silvestri
- Department of Pathology, Sapienza Rome University, Sant’Andrea Hospital
| | - Stefano Salciccia
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome
| | - Susanna Cattarino
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome
| | - Susanna Scarpa
- Department Experimental Medicine, Sapienza Rome University, Policlinico Umberto I, Rome
| | - Antonio Gatto
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome
| | | | - Magnus Von Heland
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome
| | - Gian Piero Ricciuti
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome
| | | | - Martina Maggi
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome
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Maggi M, Gentilucci A, Salciccia S, Gatto A, Gentile V, Colarieti A, Von Heland M, Busetto GM, Del Giudice F, Sciarra A. Psychological impact of different primary treatments for prostate cancer: A critical analysis. Andrologia 2018; 51:e13157. [PMID: 30281167 DOI: 10.1111/and.13157] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [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: 06/06/2018] [Revised: 08/23/2018] [Accepted: 08/27/2018] [Indexed: 01/04/2023] Open
Abstract
Limited attention has been given to the psychological impact of primary treatments in patients with prostate cancer. Aim of our analysis was to critically analyse the current evidence on the psychological impact of different primary treatments (surgery, radiotherapy and active surveillance), in patients with prostate cancer, using validated questionnaires. We searched in the MEDLINE and Cochrane library database from the literature of the past 15 years (primary fields: prostate neoplasm, AND radical prostatectomy or radiotherapy or active surveillance AND psychological distress or anxiety or depression; secondary fields: urinary, sexual, bowel modifications, non-randomised and randomised trials). Overall eighteen original and review articles were included and critically evaluated. Either radical prostatectomy or active surveillance and radiotherapy are well-tolerated in terms of definite anxiety and depression during the post-treatment follow-up. A mutual influence between functional and psychological modifications induced by treatments has been demonstrated. Urinary symptoms related to incontinence more than sexual and bowel dysfunction are able to induce psychological distress worsening. In conclusion, patients and their clinicians might wish to know how functional and psychological aspects may differently be influenced by treatment choice.
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Affiliation(s)
- Martina Maggi
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | | | - Stefano Salciccia
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Antonio Gatto
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Vincenzo Gentile
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Anna Colarieti
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Magnus Von Heland
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | - Gian Maria Busetto
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
| | | | - Alessandro Sciarra
- Department of Urology, Sapienza Rome University, Policlinico Umberto I, Rome, Italy
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Minisola F, Cipriani C, Colangelo L, Cilli M, Sciarra A, Von Heland M, Nieddu L, Anastasi E, Pascone R, Fassino V, Diacinti D, Longo F, Minisola S, Pepe J. Mineral metabolism abnormalities in patients with prostate cancer: a systematic case controlled study. Endocrine 2018; 59:338-343. [PMID: 28660378 DOI: 10.1007/s12020-017-1351-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 06/09/2017] [Indexed: 02/06/2023]
Abstract
PURPOSE Prostate cancer is the most common tumor in men. To the best of our knowledge a systematic assessment of bone and mineral abnormalities has not been performed in prostatic cancer patients consecutively enrolled. METHODS This study was therefore carried out to investigate changes of skeletal and mineral metabolism in patients with prostate cancer (n = 69). A population of patients with cancer of various origin was also investigated as a control group (n = 53), since a comparison with non-prostate cancer patients has not been previously reported. RESULTS In the prostatic cancer group, one patient had extremely high values of C-terminal Fibroblast Growth Factor 23, low values of tubular reabsorption of phosphate and very high values of bone alkaline phosphatase, suggesting the diagnosis of oncogenic osteomalacia. We found nine patients with primary hyperparathyroidism in the group of prostate cancer vs. only one in cancer patients group (p < 0.026). We stratified the population on the basis of Gleason score, prostate specific antigen and hormonal therapy. Using a generalized linear model with a logit link to predict the probability of developing primary hyperparathyroidism, only Gleason score, C-terminal fibroblast growth factor 23 and hormonal therapy had a significant effect (p < 0.05). Controlling for other covariates, a rise in fibroblast growth factor 23 increases the odds of developing primary hyperparathyroidism by 2% (p = 0.017), while patients with higher values of Gleason score have a much greater probability of developing primary hyperparathyroidism (log-odds = 3.6, p < 0.01). The probability decreases with higher values of Gleason score while on hormonal therapy; a further decrease was observed in patients on hormonal treatment and lower values of GS. Finally, lower grade of Gleason score without hormonal therapy have a significant protective factor (p < 0.01) decreasing the odds of developing primary hyperparathyroidism by 8%. CONCLUSION We showed a remarkable prevalence of primary hyperparathyroidism in men with prostate cancer; the multivariate analysis demonstrates that higher aggressiveness of prostate cancer, as determined by Gleason score, is a significant predictor of increased risk of developing primary hyperparathyroidism.
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Affiliation(s)
- Francesco Minisola
- Department of Gynecology-Obstetrics & Urology, Sapienza University of Rome, Rome, Italy
| | - Cristiana Cipriani
- Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy
| | - Luciano Colangelo
- Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy
| | - Mirella Cilli
- Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy
| | - Alessandro Sciarra
- Department of Gynecology-Obstetrics & Urology, Sapienza University of Rome, Rome, Italy
| | - Magnus Von Heland
- Department of Gynecology-Obstetrics & Urology, Sapienza University of Rome, Rome, Italy
| | - Luciano Nieddu
- Faculty of Economics, UNINT University, Via delle Sette Chiese 139, 00147, Rome, Italy
| | - Emanuela Anastasi
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Roberto Pascone
- Department of Pediatrics and Infantile Neuropsychiatry, Sapienza University of Rome, Rome, Italy
| | | | - Daniele Diacinti
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Rome, Italy
| | - Flavia Longo
- Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Rome, Italy
| | - Salvatore Minisola
- Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy.
| | - Jessica Pepe
- Department of Internal Medicine and Medical Disciplines, Sapienza University of Rome, Rome, Italy
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Alessandro S, Alessandro G, Susanna C, Michele I, Francesca DQ, Andrea F, Von Heland M, Vincenzo G, Stefano S. Laparoscopic versus open radical prostatectomy in high prostate volume cases: impact on oncological and functional results. Int Braz J Urol 2017; 42:223-33. [PMID: 27256175 PMCID: PMC4871381 DOI: 10.1590/s1677-5538.ibju.2015.0385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 07/17/2015] [Accepted: 11/16/2015] [Indexed: 12/02/2022] Open
Abstract
Background and objective: To prospectively compare the laparoscopic versus open approach to RP in cases with high prostate volume and to evaluate a possible different impact of prostate volume. Materials and Methods: From March 2007 to March 2013 a total of 120 cases with clinically localized prostate cancer (PC) and a prostate volume>70cc identified for radical prostatectomy (RP), were prospectively analyzed in our institute. Patients were offered as surgical technique either an open retropubic or an intraperitoneal laparoscopic (LP) approach. In our population, 54 cases were submitted to LP and 66 to open RP. We analyzed the association of the surgical technique with perioperative, oncological and postoperative functional parameters. Results: In those high prostate volume cases, the surgical technique (laparoscopic versus open) does not represent a significant independent factor able to influence positive surgical margins rates and characteristics (p=0.4974). No significant differences (p>0.05) in the overall rates of positive margins was found, and also no differences following stratification according to the pathological stage and nerve sparing (NS) procedure. The surgical technique was able to significantly and independently influence the hospital stay, time of operation and blood loss (p<0.001). On the contrary, in our population, the surgical technique was not a significant factor influencing all pathological and 1-year oncological or functional outcomes (p>0.05). Conclusions: In our prospective non randomized analysis on high prostate volumes, the laparoscopic approach to RP is able to guarantee the same oncological and functional results of an open approach, maintaining the advantages in terms of perioperative outcomes.
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Affiliation(s)
- Sciarra Alessandro
- Dipartimento di Urologia - Unità della prostata, Università La Sapienza, Roma, Italia
| | - Gentilucci Alessandro
- Dipartimento di Urologia - Unità della prostata, Università La Sapienza, Roma, Italia
| | - Cattarino Susanna
- Dipartimento di Urologia - Unità della prostata, Università La Sapienza, Roma, Italia
| | - Innocenzi Michele
- Dipartimento di Urologia - Unità della prostata, Università La Sapienza, Roma, Italia
| | - Di Quilio Francesca
- Dipartimento di Urologia - Unità della prostata, Università La Sapienza, Roma, Italia
| | - Fasulo Andrea
- Istituto Nazionale Italiano di Statistica - Ricercatore di Statistica, Roma, Italia
| | - Magnus Von Heland
- Dipartimento di Urologia - Unità della prostata, Università La Sapienza, Roma, Italia
| | - Gentile Vincenzo
- Dipartimento di Urologia - Unità della prostata, Università La Sapienza, Roma, Italia
| | - Salciccia Stefano
- Dipartimento di Urologia - Unità della prostata, Università La Sapienza, Roma, Italia
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Antonini G, Vicini P, Sanalone S, Garaffa G, Vitarelli A, De Berardinis E, Von Heland M, Giovannone R, Casciani E, Gentile V. Reply by authors. Arch Ital Urol Androl 2014; 86:304. [PMID: 25803879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
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Antonini G, Vicini P, Sansalone S, Garaffa G, Vitarelli A, De Berardinis E, Von Heland M, Giovannone R, Casciani E, Gentile V. Penile fracture: penoscrotal approach with degloving of penis after Magnetic Resonance Imaging (MRI). ACTA ACUST UNITED AC 2014; 86:39-40. [PMID: 24704930 DOI: 10.4081/aiua.2014.1.39] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 03/28/2014] [Indexed: 11/23/2022]
Abstract
Fracture of the penis, a relatively uncommon emergency in Urology, consists in the traumatic rupture of the tunica albuginea of the corpus cavernosum. Examination and clinical history can be highly suspicious of penile fracture in the majority of cases and ultrasonography (USS) can be useful to identify the exact location of the tunical rupture, which is proximal in 2/3 of cases and therefore manageable through a penoscrotal approach. Although expensive and not readily available in the acute setting, Magnetic Resonance Imaging (MRI) may play a role in the differential diagnosis with rupture of a circumflex or dorsal vein of the penis or when the tunical rupture is not associated with tear of the overlying Buck's fascia. This form of imaging is more sensitive than USS at identifying the presence of a tunical tear. The treatment of choice is immediate surgical repair, which allows preserving erectile function and minimizing corporeal fibrosis.
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Sciarra A, Von Heland M, Minisola F, Salciccia S, Cattarino S, Gentile V. Thulium Laser Supported Nephron Sparing Surgery for Renal Cell Carcinoma. J Urol 2013; 190:698-701. [DOI: 10.1016/j.juro.2013.01.079] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2013] [Indexed: 12/26/2022]
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Sciarra A, Cristini C, Von Heland M, Salciccia S, Gentile V. Randomized trial comparing an anterograde versus a retrograde approach to open radical prostatectomy: results in terms of positive margin rate. Can Urol Assoc J 2013. [DOI: 10.5489/cuaj.851] [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: 11/19/2022]
Abstract
Objectives: Surgical technique, patient characteristics and methodof pathological review may influence surgical margin (SM) status.Positive surgical margin (SM+) rates of 14% to 46% have beenreported in different radical retropubic prostatectomy (RRP) series.We evaluated the effect of an anterograde versus retrograde approachto RRP and specifically focused on the incidence of SM+.Methods: From January 2003 to November 2007, we randomlyassigned 200 patients with clinically localized prostate adenocarcinomasto undergo a retrograde (Group A) versus an anterograde(Group B) open RRP. All RRPs were performed at our institutionby 2 surgeons. For all 200 patients, we evaluated a panelof clinical and pathological variables relating to their associationwith SM status.Results: In Group A, 22% of cases after RRP showed a pT3 tumourand 39% of cases with a Gleason score ≥7 (4+3); in Group B,20% of cases showed a pT3 tumour and 37% of cases with aGleason score ≥7 (4+3) (p > 0.10). The incidence of SM+ was18% in Group A and 14% in Group B (p = 0.0320). In Group A,22.2% of cases with SM+ had multiple positive margins, whereasno cases in Group B showed multiple SM+. Regarding the localizationof SM+, no difference was found between the 2 groups.In the multivariate analysis, only prostate-specific antigen(p = 0.0090 and p = 0.0020, respectively in the 2 groups) andpathological stage (p < 0.0001 in both groups) were significantand independently associated with SM+ occurrence.Conclusion: In our experience, the anterograde approach to openRRP is associated with lower SM+ rates and no risk of multipleSM+ when compared with the retrograde approach.Objectifs : La technique chirurgicale, les caractéristiques du patientet la méthode d’examen pathologique peuvent tous avoir un impactsur le statut des marges chirurgicales. Des taux de marges chirurgicalespositives de 14 à 46 % ont été notés lors de différentesséries de prostatectomies radicales rétropubiennes (PRR). Nousavons évalué l’effet d’un abord antérograde ou rétrograde, plusprécisément sur l’incidence des marges chirurgicales positives.Méthodologie: Entre janvier 2003 et novembre 2007, nous avonschoisi au hasard 200 patients porteurs d’un adénocarcinome prostatiquecliniquement localisé pour qu’ils subissent une PRR ouverterétrograde (groupe A) ou antérograde (groupe B). Toutes les PRRont été réalisées à notre établissement par deux chirurgiens. Pourchacun des 200 patients, nous avons évalué un ensemble de variablescliniques et pathologiques quant à leur lien avec le statutdes marges chirurgicales.Résultats : Dans le groupe A, 22 % des patients présentaient unetumeur pT3 et 39 %, un score de Gleason ≥ 7 (4+3) après la PRR;dans le groupe B, 20 % des patients présentaient une tumeur pT3et 37 %, un score de Gleason ≥ 7 (4+3) (p > 0,10). L’incidencedes marges chirurgicales positives était de 18 % dans le groupeA et de 14 % dans le groupe B (p = 0,0320). Dans le groupe A,22,2 % des cas de marges chirurgicales positives étaient des casmultiples, tandis qu’aucun des patients du groupe B n’avaient demarges chirurgicales positives multiples. Aucune différence n’aété notée entre les deux groupes concernant l’emplacement desmarges positives. Dans l’analyse multivariée, seuls l’antigène prostatiquespécifique (p = 0,0090 et p = 0,0020, respectivement,dans les deux groupes) et le stade pathologique (p < 0,0001 dansles deux groupes) étaient significatifs et liés de façon indépendanteà la présence de marges chirurgicales positives.Conclusion: Selon nos observations, l’abord antérograde est lié àdes taux inférieurs de marges chirurgicales positives et à un risquenul de charges chirurgicales positives multiples, en comparaisonavec l’abord rétrograde.
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Sciarra A, Panebianco V, Salciccia S, Gentilucci A, Alfarone A, Dimare L, Lisi D, Catturino S, Di Pierro G, Von Heland M, Ciccariello M, Passariello R, Gentile V. Value of magnetic resonance spectroscopy (MSR) and dynamic contrast-enhanced magnetic resonance (DCEMR) imaging for the characterization of high-grade prostatic intraepithelial neoplasia (HGPIN) foci. Urol Oncol 2011; 29:634-40. [DOI: 10.1016/j.urolonc.2009.07.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2009] [Revised: 07/20/2009] [Accepted: 07/21/2009] [Indexed: 11/28/2022]
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Sciarra A, Cristini C, Von Heland M, Salciccia S, Gentile V. Randomized trial comparing an anterograde versus a retrograde approach to open radical prostatectomy: results in terms of positive margin rate. Can Urol Assoc J 2011; 4:192-8. [PMID: 20514284 DOI: 10.5489/cuaj.09089] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Surgical technique, patient characteristics and method of pathological review may influence surgical margin (SM) status. Positive surgical margin (SM+) rates of 14% to 46% have been reported in different radical retropubic prostatectomy (RRP) series. We evaluated the effect of an anterograde versus retrograde approach to RRP and specifically focused on the incidence of SM+. METHODS From January 2003 to November 2007, we randomly assigned 200 patients with clinically localized prostate adenocarcinomas to undergo a retrograde (Group A) versus an anterograde (Group B) open RRP. All RRPs were performed at our institution by 2 surgeons. For all 200 patients, we evaluated a panel of clinical and pathological variables relating to their association with SM status. RESULTS In Group A, 22% of cases after RRP showed a pT3 tumour and 39% of cases with a Gleason score >/=7 (4+3); in Group B, 20% of cases showed a pT3 tumour and 37% of cases with a Gleason score >/=7 (4+3) (p > 0.10). The incidence of SM+ was 18% in Group A and 14% in Group B (p = 0.0320). In Group A, 22.2% of cases with SM+ had multiple positive margins, whereas no cases in Group B showed multiple SM+. Regarding the localization of SM+, no difference was found between the 2 groups. In the multivariate analysis, only prostate-specific antigen (p = 0.0090 and p = 0.0020, respectively in the 2 groups) and pathological stage (p < 0.0001 in both groups) were significant and independently associated with SM+ occurrence. CONCLUSION In our experience, the anterograde approach to open RRP is associated with lower SM+ rates and no risk of multiple SM+ when compared with the retrograde approach.
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Di Silverio F, Sciarra A, Parente U, Andrea A, Von Heland M, Panebianco V, Passariello R. Neoadjuvant therapy with sorafenib in advanced renal cell carcinoma with vena cava extension submitted to radical nephrectomy. Urol Int 2008; 80:451-3. [PMID: 18587261 DOI: 10.1159/000132708] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Accepted: 02/22/2008] [Indexed: 12/31/2022]
Abstract
A 71-year-old man with advanced left renal cell carcinoma (lymph node involvement and vena cava thrombus) was submitted to 6 months of neoadjuvant treatment with sorafenib before open radical nephrectomy. After sorafenib treatment and before surgery a new CT scan confirmed the presence of a 9.0 cm in diameter solid mass in the left kidney but a reduction in thrombus extension, limited to the left renal vein. At histological examination after radical nephrectomy, over 90% of the renal mass was substituted by necrotic tissue.
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Cancrini A, De Carli P, Fattahi H, Pompeo V, Cantiani R, Von Heland M, Rowland RG. Original Articles: Bladder Cancer: Orthotopic Ileal Neobladder in Female Patients After Radical Cystectomy: 2-Year Experience. J Urol 1995. [DOI: 10.1016/s0022-5347(01)67612-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Antonio Cancrini
- From the Department of Urological Oncology, Regina Elena National Cancer Institute and Department of Urology, La Sapienza University of Rome, Rome, Italy. Department of Urology, University Hospital, Indianapolis, Indiana
| | - Piero De Carli
- From the Department of Urological Oncology, Regina Elena National Cancer Institute and Department of Urology, La Sapienza University of Rome, Rome, Italy. Department of Urology, University Hospital, Indianapolis, Indiana
| | - Hassan Fattahi
- From the Department of Urological Oncology, Regina Elena National Cancer Institute and Department of Urology, La Sapienza University of Rome, Rome, Italy. Department of Urology, University Hospital, Indianapolis, Indiana
| | - Vincenzo Pompeo
- From the Department of Urological Oncology, Regina Elena National Cancer Institute and Department of Urology, La Sapienza University of Rome, Rome, Italy. Department of Urology, University Hospital, Indianapolis, Indiana
| | - Ruggero Cantiani
- From the Department of Urological Oncology, Regina Elena National Cancer Institute and Department of Urology, La Sapienza University of Rome, Rome, Italy. Department of Urology, University Hospital, Indianapolis, Indiana
| | - Magnus Von Heland
- From the Department of Urological Oncology, Regina Elena National Cancer Institute and Department of Urology, La Sapienza University of Rome, Rome, Italy. Department of Urology, University Hospital, Indianapolis, Indiana
| | - Randell G. Rowland
- From the Department of Urological Oncology, Regina Elena National Cancer Institute and Department of Urology, La Sapienza University of Rome, Rome, Italy. Department of Urology, University Hospital, Indianapolis, Indiana
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