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Vilaseca A, Guerrero F, Zainfeld D, Shore ND, Rodriguez Faba O, Meijer RP, Witjes AA, McRee AJ, Kalota A, Stone NL, Lauring JD, Zhu W, Beeharry N, O'Dondi LA, Jayram G. Safety and efficacy of the erdafitinib (erda) intravesical delivery system, TAR-210, in patients (pts) with non–muscle-invasive bladder cancer (NMIBC) or muscle-invasive bladder cancer (MIBC) harboring select FGFR mutations or fusions: Phase 1 first-in-human study. J Clin Oncol 2023. [DOI: 10.1200/jco.2023.41.6_suppl.tps583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
Abstract
TPS583 Background: Treatment options are limited for pts with NMIBC and MIBC who experience disease recurrence or who are ineligible for or refuse standard of care. Erda, an oral selective pan-FGFR tyrosine kinase inhibitor, is approved in adults with locally advanced or metastatic urothelial cancer with select FGFR3/2 alterations ( alt) who have progressed during or after ≥1 line of platinum-containing chemotherapy. FGFRalt are among the most common oncogenic drivers detected in NMIBC and MIBC, and are more prevalent in NMIBC. TAR-210 is an intravesical drug delivery system designed to provide local, continuous release of erda within the bladder, thus limiting systemic toxicity. This study evaluates the safety, pharmacokinetics (PK), and efficacy of TAR-210 in pts with NMIBC or MIBC with select FGFRalt. Methods: Open-label, multicenter phase 1 study of TAR-210 in pts with recurrent NMIBC or MIBC (NCT05316155). Eligible pts are aged ≥18 yrs with adequate organ function and tumors with select FGFRalt. A flexible molecular eligibility strategy is used to allow for local or central fresh/archival tissue-based FGFR testing by next-generation sequencing (NGS) or PCR, or urine cell-free DNA NGS testing. Four cohorts will be enrolled: pts with recurrent, bacillus Calmette-Guerin (BCG)-experienced papillary-only high-risk (HR) NMIBC (high-grade Ta/T1) refusing or ineligible for radical cystectomy (RC) (Cohort 1) or scheduled for RC (Cohort 2); pts with recurrent, intermediate-risk NMIBC (Ta/T1) with a history of low-grade disease (Cohort 3); pts with cT2-T3a MIBC scheduled for RC refusing or ineligible for neoadjuvant cisplatin (Cohort 4). Pts in Cohorts 1 and 2 will have TURBT with resection of all visible disease prior to dosing, whereas pts in Cohort 3 must have visible disease prior to dosing. The primary end point is safety (adverse events, including dose-limiting toxicity). Secondary end points include PK, recurrence-free survival (Cohorts 1 and 2), complete response (CR) rate and duration of CR (Cohort 3), and pathologic CR rate, pT0 rate, and rate of downstaging to <pT2 (Cohort 4). Dose escalation (Part 1; n≈12, Cohorts 1 and 3 only) will be followed by dose expansion (Part 2; n≈50-80). Cohorts 1 and 3: response assessment will be after a 3-mo dosing cycle; pts with CR may receive ≤3 additional 3-mo dosing cycles if no recurrence, progression, or unacceptable toxicity. Cohorts 2 and 4: response assessment will be at RC after 8 wks of dosing. Follow-up disease surveillance (cystoscopy, urine cytology, imaging) will be every 3 mos to end of Yr 2 and every 6 mos in Yr 3 in Cohorts 1 and 3 and at 3 mos post-RC in Cohorts 2 and 4. Four pts were enrolled since April 2022 (1 in Cohort 1, 3 in Cohort 3); enrollment for Cohorts 2 and 4 is planned soon. Clinical trial information: NCT05316155 .
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Affiliation(s)
| | | | | | | | | | | | | | | | - Anna Kalota
- Janssen Research & Development, Spring House, PA
| | | | | | - Wei Zhu
- Janssen Research & Development, Raritan, NJ
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Korkes F, Timoteo F, Baccaglini W, Glina F, Faba OR, Palou Redorta J, Glina S. Postoperative Mortality Rate after Radical Cystectomy: A Systematic Review of Epidemiologic Series. Urol Int 2022; 107:96-104. [PMID: 36382647 DOI: 10.1159/000524578] [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: 10/25/2020] [Accepted: 03/21/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Mortality after radical cystectomy (RC) varies widely in the literature. In cohort studies, mortality rates can vary from as low as 0.5% in large-volume academic centers (2) to as high as 25% in developing countries series. This study aims to perform a systematic review of population-based studies reporting mortality after RC. METHODS A Systematic search was performed in Medline (PubMed®), Embase, and Cochrane for epidemiologic studies reporting mortality after RC. Institutional cohorts and those reporting mortality for specific groups within populations were excluded. Case series and non-epidemiologic series were also excluded. The aim of this review is to evaluate in-hospital mortality (IHM), 30-day mortality (30M), and 90-day mortality (90M). RESULTS Systematic search resulted in 42 papers comprising 449,661 patients who underwent RC from 1984 to 2017. Mean age was 66.1. Overall IHM, 30M, and 90M were 2.6%, 2.7%, and 4.9%, respectively, with 90M being 2.6 times higher than IHM on average. Lowest IHM was found in Canada and Australia (0.2% and 0.6%, respectively), while the highest IHM was 7.8% (Brazil). Canada and Spain showed the highest 90M (6.5%). 159,584 urinary diversions were analyzed, being mostly ileal conduits (76.8%). CONCLUSIONS The majority of the studies available are from major developed economies with paucity of data in the developing world. 90M after RC tends to be at least twice as high as IHM. The knowledge of such epidemiologic data is vital to guide public policies, such as centralization, in order to reduce mortality.
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Affiliation(s)
- Fernando Korkes
- Division of Urology, Faculdade de Medicina Do ABC, São Paulo, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Frederico Timoteo
- Division of Urology, Faculdade de Medicina Do ABC, São Paulo, Brazil, .,Hospital Israelita Albert Einstein, São Paulo, Brazil,
| | - Willy Baccaglini
- Division of Urology, Faculdade de Medicina Do ABC, São Paulo, Brazil.,Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Felipe Glina
- Division of Urology, Faculdade de Medicina Do ABC, São Paulo, Brazil
| | | | | | - Sidney Glina
- Division of Urology, Faculdade de Medicina Do ABC, São Paulo, Brazil
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Turco M, Huguet J, Territo A, Fontana M, Rodriguez Faba O, Palou J, Breda A. Outcomes following surgical management of adrenocortical carcinoma: A single-center experience. ARCH ESP UROL 2021; 74:782-789. [PMID: 34605409] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Adrenocortical carcinoma (ACC) is a rare and heterogeneous disease, with challenging management and poor prognosis. Surgery withcurative intent is the preferred treatment option for localized disease, with a reported 5-year survival rate of 55% for complete resections. However, owing to the high risk of recurrence there is a need for adjuvant therapies, such as mitotane, an adrenolytic drug, or irradiation, while in advanced disease the standard of careis a combined chemotherapy scheme. The aim of this study was to report our experience in the surgical management and outcomes of ACC patients. MATERIALS AND METHODS: A retrospective observational study was performed in a cohort of ACC patients who had undergone surgical resection (open or laparoscopic approach) and were followed up at our tertiary hospital. Patients with localized or locally advanced disease were included in the analysis. All medical records, including clinical, surgical, pathologic, and follow-updata, were collected and analyzed. RESULTS: A total of 19 ACC patients were managed at our center between August 1990 and August 2013. The median age at diagnosis was 50.5 years (range 19-72), and most patients were males. Abdominal pain was the most common clinical presentation (n=9,47.4%). Abdominal contrast-enhanced computed tomography (CT) was performed in all cases. Only 3 tumors (15.8%) were functional and most were stage II at diagnosis (n=9, 47.4%). No patient presented metastasis. Of the 19 patients, 18 (94.7%) under went surgerywith curative intent, while one (5.3%) received adjuvant radiotherapy (ART). The open approach was used in 17 patients (89.5%), while the remaining 2 (10.5%) underwent laparoscopy. Postoperative complications occurred in 8 patients (42.1%); none were of grade IV or V. Median follow-up was 66 months (range 3-312). The majority of patients (n=15, 78.9%) were disease free with surgery alone. None received adjuvant mitotane therapy (AMT). Four patients (21%) experienced metachronous metastases and 3 (15.8%) local recurrence after a median time of 10.5 months (range 2-60) and 9.3 months (range 1.5-30), respectively. The 5-year overall survival rate was 47.4%. CONCLUSIONS: Our findings confirm both the unpredictable nature of ACC and the accepted primary role of surgery. The use of adjuvant therapy was less frequent in this series than is supported currently. However, a multidiscipinary approach should be the initial step in the management of this rare malignancy.
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Affiliation(s)
- Morena Turco
- Urology Department. Fundació Puigvert. Autonomous University of Barcelona. Barcelona. Spain. Urology Department. University of Perugia. Department of Surgical and Biomedical Sciences
| | - Jorge Huguet
- Urology Department. Fundació Puigvert. Autonomous University of Barcelona. Barcelona. Spain
| | - Angelo Territo
- Urology Department. Fundació Puigvert. Autonomous University of Barcelona. Barcelona. Spain
| | - Matteo Fontana
- Urology Department. Fundació Puigvert. Autonomous University of Barcelona. Barcelona. Spain. Urology Department. Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico. Department of Clinical Sciences and Community Health. University of Milan. Milan. Italy
| | - Oscar Rodriguez Faba
- Urology Department. Fundació Puigvert. Autonomous University of Barcelona. Barcelona. Spain
| | - Joan Palou
- Urology Department. Fundació Puigvert. Autonomous University of Barcelona. Barcelona. Spain
| | - Alberto Breda
- Urology Department. Fundació Puigvert. Autonomous University of Barcelona. Barcelona. Spain
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Antonelli A, Veccia A, Pavan N, Mir C, Breda A, Takagi T, Rha KH, Maurer T, Zhang C, Long JA, De Nunzio C, Lima E, Ferro M, Micali S, Quarto G, Linares E, Celia A, Schips L, Bove P, Larcher A, Fiori C, Mottrie A, Bindayi A, Trombetta C, Silvestri T, Palou J, Faba OR, Tanabe K, Yang B, Fiard G, Tubaro A, Torres JN, De Cobelli O, Bevilacqua L, Castellucci R, Tracey A, Hampton LJ, Montorsi F, Perdonà S, Simeone C, Palumbo C, Capitanio U, Derweesh I, Porpiglia F, Autorino R. Outcomes of Partial and Radical Nephrectomy in Octogenarians – A Multicenter International Study (Resurge). Urology 2019; 129:139-145. [DOI: 10.1016/j.urology.2019.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/05/2019] [Accepted: 03/12/2019] [Indexed: 01/26/2023]
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5
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Veneziano D, Canova A, Arnolds M, Beatty JD, Biyani CS, Dehò F, Fiori C, Hellawell GO, Langenhuijsen JF, Pini G, Rodriguez Faba O, Siena G, Skolarikos A, Tokas T, Van Cleynenbreugel BSEP, Wagner C, Tripepi G, Somani B, Lima B. Performance Improvement (Pi) score: an algorithm to score Pi objectively during E-BLUS hands-on training sessions. A European Association of Urology, Section of Uro-Technology (ESUT) project. BJU Int 2018; 123:726-732. [PMID: 30431700 DOI: 10.1111/bju.14621] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 02/02/2023]
Abstract
OBJECTIVE To evaluate the variability of subjective tutor performance improvement (Pi) assessment and to compare it with a novel measurement algorithm: the Pi score. MATERIALS AND METHODS The Pi-score algorithm considers time measurement and number of errors from two different repetitions (first and fifth) of the same training task and compares them to the relative task goals, to produce an objective score. We collected data during eight courses on the four European Association of Urology training in Basic Laparoscopic Urological Skills (E-BLUS) tasks. The same tutor instructed on all courses. Collected data were independently analysed by 14 hands-on training experts for Pi assessment. Their subjective Pi assessments were compared for inter-rater reliability. The average per-participant subjective scores from all 14 proctors were then compared with the objective Pi-score algorithm results. Cohen's κ statistic was used for comparison analysis. RESULTS A total of 50 participants were enrolled. Concordance found between the 14 proctors' scores was the following: Task 1, κ = 0.42 (moderate); Task 2, κ = 0.27 (fair); Task 3, κ = 0.32 (fair); and Task 4, κ = 0.55 (moderate). Concordance between Pi-score results and proctor average scores per participant was the following: Task 1, κ = 0.85 (almost perfect); Task 2, κ = 0.46 (moderate); Task 3, κ = 0.92 (almost perfect); Task 4 = 0.65 (substantial). CONCLUSION The present study shows that evaluation of Pi is highly variable, even when formulated by a cohort of experts. Our algorithm successfully provided an objective score that was equal to the average Pi assessment of a cohort of experts, in relation to a small amount of training attempts.
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Affiliation(s)
- Domenico Veneziano
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italy
| | - Antonio Canova
- Human Resources Management, MBDA Italia SpA, Rome, Italy
| | - Michiel Arnolds
- Department of Urology, Gelre Ziekenhuis, Apeldoorn, The Netherlands
| | - John D Beatty
- Department of Urology, Leicester General Hospital, University of Leicester, Leicester, UK
| | - Chandra S Biyani
- Department of Urology, St James's University Hospital Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Federico Dehò
- Department of Urology, San Raffaele Scientific Institute, University Vita-Salute, Milan, Italy.,Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - Cristian Fiori
- Department of Oncology, A.O.U. San Luigi Gonzaga, Università degli Studi di Torino, Orbassano, Italy
| | - Giles O Hellawell
- North West London Hospitals NHS Trust, Imperial College Healthcare NHS Trust, London, UK
| | - J F Langenhuijsen
- Department of Urology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | | | | | - Giampaolo Siena
- Department of Urology, Azienda Ospedaliero-Universitaria di Careggi, Firenze, Italy
| | | | - Theodoros Tokas
- Department of Urology and Andrology, General Hospital Hall i.T., Hall in Tirol, Austria
| | | | - Christian Wagner
- Department of Urology and Oncology, St. Antonius-Hospital, Gronau, Germany
| | | | - Bhaskar Somani
- Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Bhaskar Lima
- ICVS/3B's, PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Department of Urology and Kidney Transplant, Grande Ospedale Metropolitano, Reggio Calabria, Italy
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6
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Kutikov A, Campi R, Lane B, De Cobelli O, Sanguedolce F, Villeda Sandoval C, Hatzichristodoulou G, Mari A, Antonelli A, Rodriguez Faba O, Langenhuijsen H, Klatte T, Roscigno M, Akdogan B, Karakoyunlu N, Marszalek M, Capitanio U, Volpe A, Brookman-May S, Uzzo R, Carini M, Minervini A. MP48-07 PATTERNS AND PREDICTORS OF RESECTION TECHNIQUES DURING PARTIAL NEPHRECTOMY FOR T1 RENAL MASSES: RESULTS OF A MULTICENTRE PROSPECTIVE COHORT STUDY FROM THE SURFACE-INTERMEDIATE-BASE (SIB) MARGIN SCORE INTERNATIONAL CONSORTIUM (IDEAL PHASE 2B). J Urol 2018. [DOI: 10.1016/j.juro.2018.02.1506] [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] [Indexed: 11/28/2022]
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7
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Mager R, Daneshmand S, Evans CP, Palou J, Martínez-Salamanca JI, Master VA, McKiernan JM, Libertino JA, Haferkamp A, Haferkamp A, Capitanio U, Carballido JA, Chantada V, Chromecki T, Ciancio G, Daneshmand S, Evans CP, Gontero P, González J, Hohenfellner M, Huang WC, Koppie TM, Libertino JA, Espinós EL, Lorentz A, Martínez-Salamanca JI, Master VA, McKiernan JM, Montorsi F, Novara G, O'Malley P, Pahernik S, Palou J, Moreno JLP, Pruthi RS, Faba OR, Russo P, Scherr DS, Shariat SF, Spahn M, Terrone C, Tilki D, Vázquez-Martul D, Donoso CV, Vergho D, Wallen EM, Zigeuner R. Renal cell carcinoma with inferior vena cava involvement: Prognostic effect of tumor thrombus consistency on cancer specific survival. J Surg Oncol 2016; 114:764-768. [PMID: 27562252 DOI: 10.1002/jso.24395] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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: 04/29/2016] [Accepted: 07/18/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Renal cell carcinoma forming a venous tumor thrombus (VTT) in the inferior vena cava (IVC) has a poor prognosis. Recent investigations have been focused on prognostic markers of survival. Thrombus consistency (TC) has been proposed to be of significant value but yet there are conflicting data. The aim of this study is to test the effect of IVC VTT consistency on cancer specific survival (CSS) in a multi-institutional cohort. METHODS The records of 413 patients collected by the International Renal Cell Carcinoma-Venous Thrombus Consortium were retrospectively analyzed. All patients underwent radical nephrectomy and tumor thrombectomy. Kaplan-Meier estimate and Cox regression analyses investigated the impact of TC on CSS in addition to established clinicopathological predictors. RESULTS VTT was solid in 225 patients and friable in 188 patients. Median CSS was 50 months in solid and 45 months in friable VTT. TC showed no significant association with metastatic spread, pT stage, perinephric fat invasion, and higher Fuhrman grade. Survival analysis and Cox regression rejected TC as prognostic marker for CSS. CONCLUSIONS In the largest cohort published so far, TC seems not to be independently associated with survival in RCC patients and should therefore not be included in risk stratification models. J. Surg. Oncol. 2016;114:764-768. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Rene Mager
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany.
| | | | | | - Joan Palou
- Department of Urology, Fundació Puigvert, Barcelona, Spain
| | - Juan I Martínez-Salamanca
- Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Majadahonda, Madrid, Spain
| | - Viraj A Master
- Department of Urology, Emory University, Atlanta, Georgia
| | - James M McKiernan
- Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York
| | | | - Axel Haferkamp
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany
| | | | - Axel Haferkamp
- Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany
| | - Umberto Capitanio
- Department of Urology, Hospital San Raffaele, University Vita-Salute, Milano, Italy
| | - Joaquín A Carballido
- Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
| | - Venancio Chantada
- Department of Urology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain
| | - Thomas Chromecki
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Gaetano Ciancio
- Miami Transplant Institute, University of Miami, Miami, Florida
| | | | | | - Paolo Gontero
- Department of Urology, A.O.U. San Giovanni Battista, University of Turin, Turin, Italy
| | - Javier González
- Department of Urology, Hospital Central de la Cruz Roja San José y Santa Adela, Madrid, Spain
| | | | - William C Huang
- Department of Urology, New York University School of Medicine, New York, New York
| | - Theresa M Koppie
- Department of Urology, Oregon Health and Science University, Portland, Oregon
| | | | | | - Adam Lorentz
- Department of Urology, Emory University, Atlanta, Georgia
| | - Juan I Martínez-Salamanca
- Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
| | - Viraj A Master
- Department of Urology, Emory University, Atlanta, Georgia
| | - James M McKiernan
- Department of Urology, Columbia University College of Physicians and Surgeons, New York, New York
| | - Francesco Montorsi
- Department of Urology, Hospital San Raffaele, University Vita-Salute, Milano, Italy
| | - Giacomo Novara
- Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
| | - Padraic O'Malley
- Department of Urology, Weill Cornell Medical Center, New York, New York
| | - Sascha Pahernik
- Department of Urology, University of Heidelberg, Heidelberg, Germany
| | - Joan Palou
- Department of Urology, Fundació Puigvert, Barcelona, Spain
| | | | - Raj S Pruthi
- Department of Urology, UNC at Chapel Hill, Chapel Hill, North Carolina
| | | | - Paul Russo
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Douglas S Scherr
- Department of Urology, Weill Cornell Medical Center, New York, New York
| | | | - Martin Spahn
- Department of Urology, University of Würzburg, Würzburg, Germany
| | - Carlo Terrone
- Division of Urology, Maggiore della Carita Hospital, University of Eastern Piedmont, Novara, Italy
| | - Derya Tilki
- Department of Urology, UC Davis Medical Center, Sacramento, California
| | - Dario Vázquez-Martul
- Department of Urology, Complejo Hospitalario Universitario A Coruña, Coruña, Spain
| | | | - Daniel Vergho
- Department of Urology, University of Würzburg, Würzburg, Germany
| | - Eric M Wallen
- Department of Urology, UNC at Chapel Hill, Chapel Hill, North Carolina
| | - Richard Zigeuner
- Department of Urology, Medical University of Graz, Graz, Austria
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Capitanio U, Stewart G, Klatte T, Volpe A, Akdogan B, Roscigno M, Langenhuijsen H, Marszalek M, Rodriguez Faba O, Salagierski M, Carini M, Lingard J, Da Pozzo L, Stief C, Minervini A, Brookman-May S. PD29-03 DOES AN UNEXPECTED FINAL PATHOLOGY OF PT3A RENAL CARCINOMA UNDERMINE CANCER CONTROL IN CLINICALLY T1N0M0 PATIENTS WHO WERE INITIALLY TREATED WITH NEPHRON SPARING SURGERY? J Urol 2016. [DOI: 10.1016/j.juro.2016.02.521] [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] [Indexed: 10/22/2022]
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9
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Rodriguez Faba O, Akdogan B, Marszalek M, Langenhuijsen JF, Brookman-May S, Stewart GD, Capitanio U, Sanguedolce F. Current Status of Focal Cryoablation for Small Renal Masses. Urology 2015; 90:9-15. [PMID: 26743392 DOI: 10.1016/j.urology.2015.11.041] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Revised: 11/21/2015] [Accepted: 11/30/2015] [Indexed: 12/27/2022]
Abstract
Focal cryoablation is an established minimally invasive technique for the treatment of small renal masses. Because of the lack of robust evidence, it is indicated in selected patients who have relative contraindications to extirpative approaches. With appropriate selection of patients, cryoablation is safe and effective. Main advantages are low risk for complication, minimal invasiveness, and good functional outcomes; oncological outcomes require further studies. The role of the percutaneous approach has been expanding because of its ability to reduce pain and hospitalization, the possibility of performing the procedure under sedation, and the fact that it is potentially more cost effective.
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Affiliation(s)
| | - Bullent Akdogan
- Department of Urology, Hacettepe University, School of Medicine, Ankara, Turkey
| | | | - J F Langenhuijsen
- Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Sabine Brookman-May
- Department of Urology, Ludwig Maximilian University, Campus Grosshadern, Munich, Germany
| | - Grant D Stewart
- Edinburgh Urological Cancer Group, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Umberto Capitanio
- King's College Hospital NHS Foundation Trust, Northampton General Hospital NHS Trust, Cliftonville, UK
| | - Francesco Sanguedolce
- Department of Urology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Secin FP, Castillo Cadiz O, García Marchiñena PA, Jurado Navarro A, Rovegno A, Autran A, Rodriguez Faba O, Palou Redorta J, Rozanec J, Featherstone M, Holst P, Nuñez Bragayrac L, Sotelo R, Faveretto R, Zequi S, Álvarez Maestro M, Martinez Piñeiro L, Villoldo G, Villaronga A, Abreu Clavijo D, Vidal Mora I, Finkelstein D, Monzo Gardiner JI, Schatloff O, Hernandez Porras A, Santaella Torres F, Sanchez Salas R, Davila HA, Villavicencio Mavrich H. PD29-04 HISPANO-AMERICAN EXPERIENCE IN MINIMALLY INVASIVE PARTIAL NEPHRECTOMY. J Urol 2015. [DOI: 10.1016/j.juro.2015.02.1791] [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] [Indexed: 11/17/2022]
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11
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Tilki D, Nguyen HG, Dall'Era MA, Bertini R, Carballido JA, Chromecki T, Ciancio G, Daneshmand S, Gontero P, Gonzalez J, Haferkamp A, Hohenfellner M, Huang WC, Koppie TM, Lorentz CA, Mandel P, Martinez-Salamanca JI, Master VA, Matloob R, McKiernan JM, Mlynarczyk CM, Montorsi F, Novara G, Pahernik S, Palou J, Pruthi RS, Ramaswamy K, Rodriguez Faba O, Russo P, Shariat SF, Spahn M, Terrone C, Vergho D, Wallen EM, Xylinas E, Zigeuner R, Libertino JA, Evans CP. Impact of histologic subtype on cancer-specific survival in patients with renal cell carcinoma and tumor thrombus. Eur Urol 2013; 66:577-83. [PMID: 23871402 DOI: 10.1016/j.eururo.2013.06.048] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [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: 05/12/2013] [Accepted: 06/25/2013] [Indexed: 12/31/2022]
Abstract
BACKGROUND Although different prognostic factors for patients with renal cell carcinoma (RCC) and vena cava tumor thrombus (TT) have been studied, the prognostic value of histologic subtype in these patients remains unclear. OBJECTIVE We analyzed the impact of histologic subtype on cancer-specific survival (CSS). DESIGN, SETTINGS, AND PARTICIPANTS We retrospectively analyzed the records of 1774 patients with RCC and TT who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 US and European centers. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Multivariable ordered logistic and Cox regression models were used to quantify the impact of tumor histology on CSS. RESULTS AND LIMITATIONS Overall 5-yr CSS was 53.4% (confidence interval [CI], 50.5-56.2) in the entire group. TT level (according to the Mayo classification of macroscopic venous invasion in RCC) was I in 38.5% of patients, II in 30.6%, III in 17.3%, and IV in 13.5%. Histologic subtypes were clear cell renal cell carcinoma (cRCC) in 89.9% of patients, papillary renal cell carcinoma (pRCC) in 8.5%, and chromophobe RCC in 1.6%. In univariable analysis, pRCC was associated with a significantly worse CSS (p<0.001) compared with cRCC. In multivariable analysis, the presence of pRCC was independently associated with CSS (hazard ratio: 1.62; CI, 1.01-2.61; p<0.05). Higher TT level, positive lymph node status, distant metastasis, and fat invasion were also independently associated with CSS. CONCLUSIONS In our multi-institutional series, we found that patients with pRCC and vena cava TT who underwent radical nephrectomy and tumor thrombectomy had significantly worse cancer-specific outcomes when compared with patients with other histologic subtypes of RCC. We confirmed that higher TT level and fat invasion were independently associated with reduced CSS.
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Affiliation(s)
- Derya Tilki
- Department of Urology, University of California, Davis, School of Medicine, Sacramento, CA, USA.
| | - Hao G Nguyen
- Department of Urology, University of California, Davis, School of Medicine, Sacramento, CA, USA
| | - Marc A Dall'Era
- Department of Urology, University of California, Davis, School of Medicine, Sacramento, CA, USA
| | - Roberto Bertini
- Department of Urology, Hospital San Raffaele, University Vita-Salute, Milan, Italy
| | - Joaquín A Carballido
- Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
| | - Thomas Chromecki
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Gaetano Ciancio
- Miami Transplant Institute, University of Miami, Miami, FL, USA
| | | | - Paolo Gontero
- Department of Urology, A.O.U. San Giovanni Battista, University of Turin, Turin, Italy
| | - Javier Gonzalez
- Department of Urology, Getafe University Hospital, Madrid, Spain
| | - Axel Haferkamp
- Department of Urology, University of Frankfurt, Frankfurt, Germany
| | | | - William C Huang
- Department of Urology, New York University School of Medicine, New York, NY, USA
| | - Theresa M Koppie
- Department of Urology, Oregon Health & Science University, Portland, OR, USA
| | - C Adam Lorentz
- Department of Urology, Emory University, Atlanta, GA, USA
| | - Philipp Mandel
- Institute of Empirical Economic Research, University of Leipzig, Leipzig, Germany
| | - Juan I Martinez-Salamanca
- Department of Urology, Hospital Universitario Puerta de Hierro-Majadahonda, Universidad Autónoma de Madrid, Madrid, Spain
| | - Viraj A Master
- Department of Urology, Emory University, Atlanta, GA, USA
| | - Rayan Matloob
- Department of Urology, Hospital San Raffaele, University Vita-Salute, Milan, Italy
| | - James M McKiernan
- Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Carrie M Mlynarczyk
- Department of Urology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Francesco Montorsi
- Department of Urology, Hospital San Raffaele, University Vita-Salute, Milan, Italy
| | | | - Sascha Pahernik
- Department of Urology, University of Heidelberg, Heidelberg, Germany
| | - Juan Palou
- Department of Urology, Fundació Puigvert, Barcelona, Spain
| | - Raj S Pruthi
- Department of Urology, UNC at Chapel Hill, Chapel Hill, NC, USA
| | - Krishna Ramaswamy
- Department of Urology, New York University School of Medicine, New York, NY, USA
| | | | - Paul Russo
- Department of Surgery, Urology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna General Hospital, Vienna, Austria
| | | | - Carlo Terrone
- Division of Urology, Maggiore della Carita Hospital, University of Eastern Piedmont, Novara, Italy
| | | | - Eric M Wallen
- Department of Urology, UNC at Chapel Hill, Chapel Hill, NC, USA
| | | | - Richard Zigeuner
- Department of Urology, Medical University of Graz, Graz, Austria
| | | | - Christopher P Evans
- Department of Urology, University of California, Davis, School of Medicine, Sacramento, CA, USA
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Tilki D, Dall'Era MA, Nguyen HG, Bertini R, Carballido JA, Chromecki T, Ciancio G, Daneshmand S, Gontero P, Gonzalez J, Haferkamp A, Hohenfellner M, Huang WC, Koppie TM, Lorentz A, Martinez-Salamanca JI, Master VA, Matloob R, McKiernan JM, Mlynarczyk CM, Montorsi F, Novara G, Pahernik S, Palou J, Pruthi RS, Ramaswamy K, Rodriguez Faba O, Russo P, Shariat SF, Spahn M, Terrone C, Vergho D, Wallen EM, Xylinas E, Zigeuner R, Libertino JA, Evans CP. 1830 IMPACT OF HISTOLOGIC SUBTYPE ON TUMOR THROMBUS LEVEL AND CANCER-SPECIFIC SURVIVAL IN PATIENTS WITH RENAL CELL CARCINOMA AND VENA CAVA THROMBUS. J Urol 2013. [DOI: 10.1016/j.juro.2013.02.2213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Breda A, Villamizar JM, Faba OR, Caliolo C, de Gracia A, Gausa L, de Leon JP, Villavicencio H. Laparoscopic live donor nephrectomy with the use of 3-mm instruments and laparoscope: initial experience at a tertiary center. Eur Urol 2011; 61:840-4. [PMID: 22176782 DOI: 10.1016/j.eururo.2011.11.038] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 11/22/2011] [Indexed: 11/29/2022]
Abstract
Laparoscopy has become the standard of care for kidney recovery during live donor nephrectomy (LDN) because of the well-documented better outcomes of minimally invasive surgery compared with the open approach. Especially in the donor population, the cosmetic results are of great importance; therefore, an effort to reduce the incision size should be attempted while maintaining the safe general principles of surgery. We present our initial experience with the use of 3-mm instruments for laparoscopic LDN.
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Affiliation(s)
- Alberto Breda
- Department of Urology, Universidad Autonoma de Barcelona, Fundaciò Puigvert, Barcelona, Spain.
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Rodriguez Faba O, Palou J, Rosales A, Breda A, Algaba F, Urdaneta G, Villavicencio H. Clinical predictive factors of poor outcome in patients with stage pT0 disease at radical cystectomy. J Urol 2011; 186:442-7. [PMID: 21679981 DOI: 10.1016/j.juro.2011.03.134] [Citation(s) in RCA: 13] [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] [Received: 12/14/2010] [Indexed: 11/15/2022]
Abstract
PURPOSE We evaluated new pre-cystectomy predictive factors for outcomes in patients with no evidence of residual tumor at cystectomy (pT0). MATERIALS AND METHODS A total of 1,114 patients underwent radical cystectomy at our institution between August 1978 and June 2002, of whom 141 (12.66%) had stage pT0. We analyzed overall and disease specific survival in relation to pre-cystectomy predictive factors, such as clinical stage, grade, size, previous nonmuscle invasive disease, number of previous recurrences, associated carcinoma in situ and lymphovascular invasion in the transurethral resection. Other factors analyzed were lymph node (N+) at cystectomy and induction chemotherapy. RESULTS Clinical stage was cTa in 10 patients, cT1 in 34, cT2 in 55, cT3 in 30 and cTis in 12. At a median followup of 42.5 months overall survival was 62.53% and disease specific survival was 79.14%. Metastatic disease developed in 17 cases (12.1%). Univariate analysis revealed worse disease specific survival in patients in whom muscle invasive tumor developed after nonmuscle invasive disease (p<0.05), and in those who presented with 5 or more previous recurrences (p<0.05), lymphovascular invasion in the transurethral resection (p<0.05) and N+ at cystectomy (p<0.05). Multivariate analysis confirmed a statistically significant association between disease specific survival and 5 or more previous recurrences (HR 1.5, 95% CI 1.07-2.10, p=0.018), muscle invasive tumor after nonmuscle invasive disease (HR 4.4, 95% CI 1.20-16.5, p=0.026) and lymphovascular invasion in the transurethral resection (HR 1.7, 95% CI 1.12-2.30, p=0.04). CONCLUSIONS Although clinical outcomes in patients with stage pT0 disease are often excellent, metastatic disease develops in a percentage of them. Muscle invasive tumor after primary nonmuscle invasive disease, 5 or more previous recurrences and lymphovascular invasion in the transurethral resection predict poor survival.
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Affiliation(s)
- Oscar Rodriguez Faba
- Department of Urology and Section of Pathology (FA), Universitat Autonoma de Barcelona, Fundació Puigvert, Barcelona, Spain.
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Rodriguez Faba O, Rosales A, Breda A, Palou J, Gaya JM, Esquena S, Gausa L, Villavicencio H. Simplified Technique for Parastomal Hernia Repair After Radical Cystectomy and Ileal Conduit Creation. Urology 2011; 77:1491-4. [PMID: 21310469 DOI: 10.1016/j.urology.2010.11.047] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Revised: 11/22/2010] [Accepted: 11/30/2010] [Indexed: 11/27/2022]
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Faba OR, Palou J, Urdaneta G, Gausa L, Villavicencio H. Invasive bladder cancer in the eighties: transurethral resection or cystectomy? Int Braz J Urol 2011; 37:49-55;discussion 55-6. [DOI: 10.1590/s1677-55382011000100007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2010] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - Joan Palou
- Universitat Autonoma de Barcelona, Spain
| | | | - Luis Gausa
- Universitat Autonoma de Barcelona, Spain
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Villavicencio H, Rodriguez Faba O, Palou J, Gausa L, Algaba F, Marcuello E. Bladder Preservation Strategy Based on Combined Therapy in Patients with Muscle-Invasive Bladder Cancer: Management and Results at Long-Term Follow-Up. Urol Int 2010; 85:281-6. [DOI: 10.1159/000316076] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Accepted: 05/31/2010] [Indexed: 11/19/2022]
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