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Cignoli D, Manica M, Pellucchi F, Licini L, Da Pozzo LF, Roscigno M. Isolated ureteral malakoplakia: A conservative endoscopic approach with a strict follow-up. Urol Case Rep 2022; 41:101986. [PMID: 35024342 PMCID: PMC8724929 DOI: 10.1016/j.eucr.2021.101986] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 12/13/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022] Open
Abstract
Ureteral malakoplakia is a rare pathological entity. We report the case of a 54-years-old woman with a single ureteral malakoplakic lesion. Patient presented with history of recurrent urinary tract infections and asymptomatic dilatation of right pelvis. Radiological investigations showed a right lower ureteric filling defect without bladder or kidney involvement. A first uretero-renoscopy allowed an extirpative biopsy, with a histopathologic diagnosis of malakoplakia. Second-look uretero-renoscopy showed only a minute area of hyperemic mucosa that was biopsied and coagulated, showing a residual focus of malakoplakia. At 12-months, imaging and blood test demonstrated reduction of hydronephrosis, serum creatinine recovery and no recurrences.
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Affiliation(s)
- Daniele Cignoli
- Unit of Urology, Division of Experimental Oncology, URI - Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
- Corresponding author. Department of Urology, IRCCS San Raffaele Hospital, via Olgettina n°60, 20132, Milan (MI), Italy.
| | - Michele Manica
- Department of Urology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Federico Pellucchi
- Department of Urology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Lisa Licini
- Department of Pathology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Luigi F. Da Pozzo
- Department of Urology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Marco Roscigno
- Department of Urology, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
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Naspro R, La Croce G, Finati M, Roscigno M, Pellucchi F, Sodano M, Manica M, Gianatti A, Da Pozzo LF. Oncological outcomes of concomitant carcinoma in situ at radical cystectomy in pure urothelial bladder cancer and in histological variants. Urol Oncol 2021; 40:61.e9-61.e19. [PMID: 34334293 DOI: 10.1016/j.urolonc.2021.07.009] [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: 04/10/2021] [Revised: 06/14/2021] [Accepted: 07/02/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The presence of carcinoma in situ at transurethral resection is known to increase the risk of recurrence and progression to invasive disease. However, the evidence regarding the prognostic role of concomitant carcinoma in situ after radical cystectomy due to bladder cancer is controversial. Moreover, concomitant carcinoma in situ was found to be significantly associated with bladder histological variants. The aim of our study is to evaluate whether the presence of concomitant carcinoma in situ at radical cystectomy, impacts on recurrence and survival outcomes in pure urothelial bladder cancer, compared to histological variants. METHODS We evaluated 410 consecutive patients diagnosed with non-metastatic bladder cancer and treated with radical cystectomy at a single tertiary referral centre between January 2009 and May 2019. Patients were stratified according to the presence of carcinoma in situ. The Kaplan-Meier method was used to compare recurrence free, cancer specific and overall survival in pure urothelial and histological variants. Cox proportional hazards regression analyses model was used to predict recurrence, cancer specific and overall mortality in pure urothelial and histological variants bladder cancer, according to pathological stage. RESULTS Median age was 71 years. 340 patients (82%) were male. At a median follow-up of 32 months, disease recurrence, cancer specific mortality and overall mortality were, 37% (155 patients), 32.9% (135 patients) and 46.6% (191 patients), respectively. Concomitant and pure carcinoma in situ were found in 39% and 19% of radical cystectomy specimens, respectively. Concomitant carcinoma in situ was more frequent in patients with histological variants (50.9%) compared to pure urothelial bladder cancer (35.4%) (P-value <.001) and was associated with worst pathological features (lymphovascular invasion, lymph node involvement and non-organ confined disease). Recurrence free survival at Kaplan-Meyer analyses was significantly higher in patients with pure carcinoma in situ compared to those with concomitant or no carcinoma in situ (all P <.001), similarly for patients without carcinoma in situ compared with those with concomitant Cis (P =.02) at radical cystectomy. Cancer specific and overall survival were significantly higher in patients with pure carcinoma in situ compared to those with concomitant or no carcinoma in situ (all P <.001). Conversely no significant difference was found between patients without carcinoma in situ and with concomitant carcinoma in situ (P>0.1) at radical cystectomy Moreover, concomitant carcinoma in situ at radical cystectomy in histological variants is associated with higher free recurrence rate compared to the other groups. At multivariate Cox proportional hazards regression analyses the presence of carcinoma in situ at radical cystectomy was not associated with any survival effect or recurrence (all P > .05) in the overall population and when patients are stratified according to histology. However, concomitant carcinoma in situ represents an independent predictor of recurrence in the subgroup of patients with organ confined disease in case of urothelial bladder cancer and histological variants. CONCLUSION Concomitant carcinoma in situ should be considered a proxy of aggressiveness in bladder cancer after radical cystectomy. Based on its prognostic implications, concomitant carcinoma in situ should be considered for strict follow-up in patients with organ confined disease which may deserve adjuvant treatment both in pure urothelial bladder cancer and histological variants.
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Affiliation(s)
- Richard Naspro
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
| | | | | | - Marco Roscigno
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Mario Sodano
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Michele Manica
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Andrea Gianatti
- Department of Pathology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Luigi F Da Pozzo
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy; University of Milano-Bicocca, Milan, Italy
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Manica M, Roscigno M, Naspro R, Sodano M, Milesi L, Gianatti A, Da Pozzo LF. Recurrent retroperitoneal solitary fibrous tumor: a case report and review of the literature. Tumori 2020; 107:NP11-NP14. [PMID: 33238803 DOI: 10.1177/0300891620974763] [Citation(s) in RCA: 4] [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] [Indexed: 12/27/2022]
Abstract
BACKGROUND Solitary fibrous tumor (SFT) is a rare mesenchymal neoplasm described initially in visceral pleura but can occasionally involve other sites such as the urinary tract. Extrapleural localizations are often indolent but some malignant SFTs have been described. The treatment and the most important prognostic factor for SFT seem to be complete resection of the neoplasm. CASE REPORT We report the 10-year history of a retroperitoneal SFT, which recurred twice after conservative management, and was eventually treated with en bloc resection of the mass, the bladder, and the prostate, and urinary diversion by ileal conduit. To our knowledge, this case has the longest follow-up in the literature. CONCLUSION Extrapleural SFTs often have indolent but unpredictable behavior as they can recur even after many years. Some histologic features are associated with the malignancy of these tumors. Complete resection of the neoplasm is the most important prognostic factor. Patients with SFT should be considered for a very long follow-up after the surgery due to the risk of possible late recurrences.
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Affiliation(s)
- Michele Manica
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Marco Roscigno
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Richard Naspro
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Mario Sodano
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Laura Milesi
- Department of Oncology, ASST Papa Giovanni XXIII, Bergamo, Lombardia, Italy
| | - Andrea Gianatti
- Department of Pathology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Luigi F Da Pozzo
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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Roscigno M, Naspro R, Piccichè A, Muttin F, Angiolilli D, Deiana G, Pezzoli F, Da Pozzo LF. A Snapshot from the Department of Urology in Bergamo Evaluating the Timeline of the SARS-CoV-2 Outbreak: Which Patients Are We Missing? Eur Urol Focus 2020; 6:1120-1123. [PMID: 32522412 PMCID: PMC7274596 DOI: 10.1016/j.euf.2020.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 05/06/2020] [Accepted: 05/29/2020] [Indexed: 11/30/2022]
Abstract
The province of Bergamo in Italy and in particular Papa Giovanni XXIII Hospital was one of the first areas to be hit by the SARS-CoV-2 outbreak and experience firsthand all the different phases of the crisis. We describe the timeline of the changes in overall urological workload during the outbreak period from lockdown to the slow reopening of activities. We sought to compare the 2020 hospital scenario with normality in the same period in 2019, highlighting the rationale behind decision-making when guidelines were not yet available. While we focus on the changes in surgical volumes for both elective (oncological and noncancer) and urgent cases, we have still to confront the risk of untreated and underdiagnosed patients. Patient summary We present a snapshot of changes in urology during the peak of the COVID-19 outbreak in our hospital in Bergamo, Italy. The effect of medical lockdown on outcomes for untreated or underdiagnosed patients is still unknown.
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Affiliation(s)
- Marco Roscigno
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy.
| | - Richard Naspro
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Antonio Piccichè
- Department of Healthcare Coordination, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Fabio Muttin
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy; Urological Research Institute, Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Fabio Pezzoli
- Department of Healthcare Coordination, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Luigi F Da Pozzo
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy; University of Milano-Bicocca, Milan, Italy
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Roscigno M, Stabile A, Lughezzani G, Pepe P, Dell’Atti L, Naselli A, Naspro R, Nicolai M, La Croce G, Muhannad A, Perugini G, Guazzoni G, Montorsi F, Balzarini L, Sironi S, Da Pozzo LF. Multiparametric magnetic resonance imaging and clinical variables: Which is the best combination to predict reclassification in active surveillance patients? Prostate Int 2020; 8:167-172. [PMID: 33425794 PMCID: PMC7767935 DOI: 10.1016/j.prnil.2020.05.003] [Citation(s) in RCA: 4] [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: 04/10/2020] [Revised: 04/25/2020] [Accepted: 05/14/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction & objectives We tested the role of multiparametric magnetic resonance imaging (mpMRI) in disease reclassification and whether the combination of mpMRI and clinicopathological variables could represent the most accurate approach to predict the risk of reclassification during active surveillance. Materials & methods Three-hundred eighty-nine patients (pts) underwent mpMRI and subsequent confirmatory or follow-up biopsy according to the Prostate Cancer Research International Active Surveillance (PRIAS) protocol. Pts with negative (−) mpMRI underwent systematic random biopsy. Pts with positive (+) mpMRI [Prostate Imaging Reporting and Data System, version 2 (PI-RADS-V2) score ≥3] underwent targeted + systematic random biopsies. Multivariate analyses were used to create three models predicting the probability of reclassification [International Society of Urological Pathology ≥ Grade Group 2 (GG2)]: a basic model including only clinical variables (age, prostate-specific antigen density, and number of positive cores at baseline), an Magnetic resonance imaging (MRI) model including only the PI-RADS score, and a full model including both the previous ones. The predictive accuracy (PA) of each model was quantified using the area under the curve. Results mpMRI negative (−) was recorded in 127 (32.6%) pts; mpMRI positive (+) was recorded in 262 pts: 72 (18.5%) had PI-RADS 3, 150 (38.6%) PI-RADS 4, and 40 (10.3%) PI-RADS 5 lesions. At a median follow-up of 12 months, 125 pts (32%) were reclassified to GG2 prostate cancer. The rate of reclassification to GG2 prostate cancer was 17%, 35%, 38%, and 52% for mpMRI (−), PI-RADS 3, 4, and 5, respectively (P < 0.001). The PA was 69% and 64% in the basic and MRI models, respectively. The full model had the best PA of 74%: older age (P = 0.023; Odds ratio (OR) = 1.040), prostate-specific antigen density (P = 0.037; OR = 1.324), number of positive cores at baseline (P = 0.001; OR = 1.441), and PI-RADS 3, 4, and 5 (overall P = 0.001; OR = 2.458, 3.007, and 3.898, respectively) were independent predictors of reclassification. Conclusions Disease reclassification increased according to the PI-RADS score increase, at confirmatory or follow-up biopsy. However, a no-negligible rate of reclassification was found also in cases of mpMRI (−). The combination of mpMRI and clinicopathological variables still represents the most accurate approach to pts on active surveillance.
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Affiliation(s)
- Marco Roscigno
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
- Corresponding author. Dept. of Urology, ASST Papa Giovanni XXIII, Piazza OMS 1, 24127, Bergamo, Italy.
| | - Armando Stabile
- Department of Urology and Division of Experimental Oncology, URI, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Lughezzani
- Department of Urology, Istituto Clinico Humanitas IRCCS-Clinical and Research Hospital, Rozzano, Italy
| | - Pietro Pepe
- Urology Unit, Cannizzaro Hospital, Catania, Italy
| | - Lucio Dell’Atti
- Department of Urology, University Hospital “Ospedali Riuniti” and Polythecnic University of Marche Region, Ancona, Italy
| | - Angelo Naselli
- Urology Department, Ospedale San Giuseppe, Gruppo Multimedica, Milan, Italy
| | - Richard Naspro
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Maria Nicolai
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | | | - Giorgio Guazzoni
- Department of Urology, Istituto Clinico Humanitas IRCCS-Clinical and Research Hospital, Rozzano, Italy
- Department of Biomedical Science, Humanitas University, Milan, Rozzano, Italy
| | - Francesco Montorsi
- Department of Urology and Division of Experimental Oncology, URI, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luca Balzarini
- Dept. of Radiology, Humanitas Clinical and Research Center, Humanitas University, Rozzano, Italy
| | - Sandro Sironi
- Department of Radiology, ASST Papa Giovanni XXIII, Bergamo, Italy
- University of Milano-Bicocca, School of Medicine and Surgery, Monza, Italy
| | - Luigi F. Da Pozzo
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
- University of Milano-Bicocca, School of Medicine and Surgery, Monza, Italy
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Roscigno M, La Croce G, Naspro R, Nicolai M, Manica M, Scarcello M, Chinaglia D, Da Pozzo LF. Extended pelvic lymph node dissection during radical prostatectomy: comparison between initial robotic experience of a high-volume open surgeon and his contemporary open series. MINERVA UROL NEFROL 2019; 71:597-604. [PMID: 31144491 DOI: 10.23736/s0393-2249.19.03404-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this study was to evaluate intra- and perioperative outcomes of a single high volume open radical prostatectomy (ORP) surgeon, during his learning curve period for robot-assisted radical prostatectomy (RARP) and extended pelvic lymph node dissection (ePLND). METHODS The study included 264 intermediate-high risk prostate cancer patients, treated by ORP + ePLND or RARP + ePLND, prospectively collected. Descriptive statistics compared clinical and pathological variables between groups. Bivariate (Pearson) correlation analysis assessed the relationship between the number of lymph node (LN) removed, positive surgical margins (PSM), surgical time and the number of procedures performed per group. RESULTS pT stage and Gleason score (GS) were lower in RARP than in ORP group (both P=0.04), while PSM were more frequent in the RARP group (40% vs. 25%; P=0.02). However, PSM decreased with the increase of RARP procedures. The number of LNs removed was 25 and 22, in RARP and ORP group (P=0.03). However, LN+ rate did not differ between groups (11% vs. 16%; P=0.216). In the RARP group, overall surgical time and ePLND time decreased with the increase of surgical procedures (all P<0.001). CONCLUSIONS RARP requires significant learning curve to reduce operative room time and obtain PSM comparable to those of an ORP high-volume surgeon. On the contrary, the quality of ePLND during RARP seems to be not related to the number of procedures performed, allowing removal of a number of LNs that is clinically comparable to ORP.
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Affiliation(s)
- Marco Roscigno
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | - Richard Naspro
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Maria Nicolai
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Michele Manica
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | - Luigi F Da Pozzo
- Department of Urology, ASST Papa Giovanni XXIII, University of Milano Bicocca, Bergamo, Italy
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Antonelli A, Francavilla S, Gallotta A, Da Pozzo LF, Ferretti S, Sigala S, Simeone C, Mirone V, Artibani W, Porreca A. Current evidence and future perspectives about the role of iXip® in the diagnosis of prostate cancer. MINERVA UROL NEFROL 2019; 71:201-204. [DOI: 10.23736/s0393-2249.19.03329-0] [Citation(s) in RCA: 4] [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] [Indexed: 11/08/2022]
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Roscigno M, Nicolai M, La Croce G, Pellucchi F, Scarcello M, Saccà A, Angiolilli D, Chinaglia D, Da Pozzo LF. Difference in Frequency and Distribution of Nodal Metastases Between Intermediate and High Risk Prostate Cancer Patients: Results of a Superextended Pelvic Lymph Node Dissection. Front Surg 2018; 5:52. [PMID: 30246012 PMCID: PMC6137230 DOI: 10.3389/fsurg.2018.00052] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/07/2018] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate the frequency and distribution of pelvic nodes metastases, in intermediate-high risk prostate cancer (PCa) patients (pts), who underwent open radical prostatectomy (ORP) and superextended pelvic lymph node dissection (sePLND). Patients and Methods: We retrospectively evaluated 630 consecutive pts with clinically localized, intermediate-high risk PCa, treated with ORP and sePLND from 2009 to 2016 at a single institution. The sePLND always removed all nodal/fibro-fatty tissue of the internal iliac, external iliac, obturator, common iliac, and presacral regions. Results: Positive lymph nodes (LN+) were found in 133 pts (21.1%). The median number of removed nodes and LN+ was 25 and 1, respectively. LN+ were found in 64 (48.1%), 58 (43.6%), 53 (39.8%), 16 (12%), and 20 (15%) pts and were present as a single site in 27 (20.3%), 22 (16.5%), 20 (15%), 0, and 6 (4.5%) cases in the internal iliac, external iliac, obturator, common iliac, and presacral chain, respectively. An ePLND would have correctly staged 127 (95%) pts but removed all LN+ in only 97 (73%) pts. Presacral nodes harbored LN+ in 20 patients. Among them, 18 were high-risk patients. Moreover, all but 1 pts with common iliac LN+ were in high risk group. Conclusions: These results suggest that removal of presacral and common iliac nodes could be omitted in intermediate risk pts. However, a PLND limited to external iliac, obturator, and internal iliac region may be adequate for nodal staging purpose, but not enough accurate if we aim to remove all possible site of LN+ in high risk pts.
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Affiliation(s)
- Marco Roscigno
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Maria Nicolai
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
| | | | | | | | - Antonino Saccà
- Department of Urology, ASST Papa Giovanni XXIII, Bergamo, Italy
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Roscigno M, Nicolai M, Naspro RLJ, Pellucchi F, Cornaghi LB, Chinaglia D, Saccà A, Da Pozzo LF. MP47-11 EXTENDED PELVIC LYMPH NODE DISSECTION FOR INTERMEDIATE-HIGH RISK PROSTATE CANCER: FREQUENCY AND DISTRIBUTION OF NODAL METASTASES. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1471] [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: 10/19/2022]
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Casabé A, Roehrborn CG, Da Pozzo LF, Zepeda S, Henderson RJ, Sorsaburu S, Henneges C, Wong DG, Viktrup L. Efficacy and Safety of the Coadministration of Tadalafil Once Daily with Finasteride for 6 Months in Men with Lower Urinary Tract Symptoms and Prostatic Enlargement Secondary to Benign Prostatic Hyperplasia. J Urol 2014; 191:727-33. [DOI: 10.1016/j.juro.2013.09.059] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2013] [Indexed: 01/22/2023]
Affiliation(s)
- Adolfo Casabé
- Instituto Médico Especializado, Buenos Aires, Argentina
| | | | - Luigi F. Da Pozzo
- Department of Urology, Ospedale Papa Giovanni XXIII-Bergamo, Bergamo, Italy
| | | | | | | | - Carsten Henneges
- Global Statistical Sciences, Lilly Deutschland GmbH, Bad Homburg, Germany
| | - David G. Wong
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana
| | - Lars Viktrup
- Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, Indiana
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Roscigno M, Naspro R, Ceresoli F, Di Trapani E, Matloob R, Carenzi C, Deiana G, Capitanio U, Rigatti P, Montorsi F, Da Pozzo LF, Bertini R. 1851 RENAL AND CARDIOVASCULAR MORBIDITY AFTER PARTIAL OR RADICAL NEPHRECTOMY IN PATIENTS WITH KIDNEY TUMORS UP TO 7 CENTIMETERS: IMPLICATIONS ON OVERALL MORTALITY. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.1961] [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: 11/24/2022]
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Roscigno M, Scattoni V, Freschi M, Abdollah F, Maccagnano C, Galosi A, Lacetera V, Montironi R, Muzzonigro G, Deho F, Deiana G, Belussi D, Chinaglia D, Montorsi F, Da Pozzo LF. Diagnosis of isolated high-grade prostatic intra-epithelial neoplasia: proposal of a nomogram for the prediction of cancer detection at saturation re-biopsy. BJU Int 2011; 109:1329-34. [PMID: 21895935 DOI: 10.1111/j.1464-410x.2011.10532.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
UNLABELLED Study Type--Diagnostic (case series). Level of Evidence 4. What's known on the subject? And what does the study add? Multifocality, age, PSA values, and biopsy protocols regarding the predictive value of high grade PIN have been discussed extensively in the literature. Our study developed for the first time a predictive nomogram that could be helpful for patient counselling and to guide the urologist to perform rPBX after an initial diagnosis of isolated HGPIN. OBJECTIVE • To evaluate factors that may predict prostate cancer (PCa) detection after the initial diagnosis of high-grade prostatic intra-epithelial neoplasia (HGPIN) on prostate biopsy (PBx) with six to 24 random cores. PATIENTS AND METHODS • We retrospectively evaluated 262 patients submitted from 1998 to 2007 to prostate re-biopsy (rPBx) after an initial HGPIN diagnosis in tertiary academic centres. • HGPIN diagnosis was obtained on initial systematic PBx with six to 24 random cores. • All patients were re-biopsied with a 'saturation' rPBx with 20-26 cores, with a median time to rPBx of 12 months. • All slides were reviewed by expert uropathologists. RESULTS • Plurifocal HGPIN (pHGPIN) was found in 115 patients and monofocal HGPIN (mHGPIN) was found in 147 patients. • In total, 108 and 154 patients, respectively, were submitted to >12-core initial PBx and ≤12-core initial PBx. • Overall PCa detection at rPBx was 31.7%. PSA level (7.7 vs 6.6 ng/mL; P= 0.031) and age (68 vs 64 years; P= 0.001) were significantly higher in patients with PCa at rPBx. • PCa detection was significantly higher in patients with a ≤12-core initial PBx than in those with a >12-core initial PBx (37.6% vs 23.1%; P= 0.01), as well as in patients with pHGPIN than in those with mHGPIN (40% vs 25.1%; P= 0.013). • At multivariable analysis, PSA level (P= 0.041; hazards ratio, HR, 1.08), age (P < 0.001; HR, 1.09), pHGPIN (P= 0.031; HR, 1.97) and ≤12-core initial PBx (P= 0.012; HR, 1.95) were independent predictors of PCa detection. • A nomogram including these four variables achieved 72% accuracy for predicting PCa detection after an initial HGPIN diagnosis. CONCLUSIONS • PCa detection on saturation rPBx after an initial diagnosis of HGPIN is significantly higher in patients with a ≤12-core initial PBx than those with a >12-core initial PBx and in patients with pHGPIN than in those with mHGPIN. • We developed a simple prognostic tool for the prediction of PCa detection in patients with initial HGPIN diagnosis who were undergoing saturation rPBx.
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Affiliation(s)
- Marco Roscigno
- Department of Urology and Pathology, Ospedali Riuniti di Bergamo, Bergamo, Italy.
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Rigatti P, Suardi N, Briganti A, Da Pozzo LF, Tutolo M, Villa L, Gallina A, Capitanio U, Abdollah F, Scattoni V, Colombo R, Freschi M, Picchio M, Messa C, Guazzoni G, Montorsi F. Pelvic/retroperitoneal salvage lymph node dissection for patients treated with radical prostatectomy with biochemical recurrence and nodal recurrence detected by [11C]choline positron emission tomography/computed tomography. Eur Urol 2011; 60:935-43. [PMID: 21840116 DOI: 10.1016/j.eururo.2011.07.060] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2011] [Accepted: 07/25/2011] [Indexed: 01/10/2023]
Abstract
BACKGROUND The management of patients with clinical recurrence of prostate cancer after radical prostatectomy (RP) remains challenging. OBJECTIVE To determine whether the removal of positive lymph nodes at [11C]choline positron emission tomography/computed tomography (PET/CT) scan may have an impact on the prognosis of patients with biochemical recurrence (BCR) and nodal recurrence after RP. DESIGN, SETTING, AND PARTICIPANTS Prospective analysis of 72 patients affected by BCR after RP associated with a nodal pathologic [11C]choline PET/CT scan. INTERVENTION Patients underwent salvage lymph node dissection (LND). MEASUREMENTS Biochemical response (BR) to treatment was defined as prostate-specific antigen (PSA) <0.2 ng/ml at 40 d after salvage LND. Kaplan-Meier and Cox regression analyses addressed time to and predictors of clinical recurrence (CR) after salvage LND, respectively. RESULTS AND LIMITATIONS Overall, 56.9% of patients achieved BR. Mean and median follow-up after LND were 39.4 and 39.8 mo, respectively. The 5-yr BCR-free survival rate was 19%. Preoperative PSA <4 ng/ml (hazard ratio [HR]: 0.12; p = 0.005), time to BCR <24 mo (HR: 7.52; p = 0.005), and negative lymph nodes at previous RP (HR: 0.19; p=0.04) represented independent predictors of BR. Overall, 5-yr CR-free and cancer-specific survival were 34% and 75%, respectively. At multivariable analyses, only PSA >4 ng/ml (HR: 2.13; p=0.03) and the presence of retroperitoneal uptake at PET/CT scan (HR=2.92; p=0.004) represented independent preoperative predictors of CR. Similarly, the presence of pathologic nodes in the retroperitoneum (HR: 2.78; p=0.02), higher number of positive lymph nodes (HR: 1.04; p=0.006), and complete BR to salvage LND (HR: 0.31; p=0.002) represented postoperative independent predictors of CR. Main limitations consisted of the lack of a control group and the heterogeneity of patients included in the analyses. CONCLUSIONS Salvage LND is feasible in patients with BCR after RP and nodal pathologic uptake at [11C]choline PET/CT scan. Biochemical response after surgery can be achieved in a consistent proportion of patients. Although most patients invariably progressed to BCR after surgery at longer follow-up, 35% of patients showed the absence of CR at 5 yr.
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Affiliation(s)
- Patrizio Rigatti
- Department of Urology, Urological Research Institute, University Vita-Salute San Raffaele, Milan, Italy
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Salonia A, Gallina A, Briganti A, Colombo R, Bertini R, Da Pozzo LF, Zanni G, Sacca A, Rocchini L, Guazzoni G, Rigatti P, Montorsi F. Postoperative Orgasmic Function Increases over Time in Patients Undergoing Nerve-Sparing Radical Prostatectomy. J Sex Med 2010; 7:149-55. [DOI: 10.1111/j.1743-6109.2009.01518.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Salonia A, Zanni G, Gallina A, Briganti A, Saccà A, Suardi N, Matloob R, Da Pozzo LF, Bertini R, Colombo R, Rigatti P, Montorsi F. Unsuccessful Investigation of Preoperative Sexual Health Issues in the Prostate Cancer “Couple”: Results of a Real‐Life Psychometric Survey at a Major Tertiary Academic Center. J Sex Med 2009; 6:3347-55. [DOI: 10.1111/j.1743-6109.2009.01483.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Da Pozzo LF. Editorial comment on: Adjuvant high-dose intensity-modulated radiotherapy after radical prostatectomy for prostate cancer: clinical results in 104 patients. Eur Urol 2009; 56:675-6. [PMID: 19501455 DOI: 10.1016/j.eururo.2009.05.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Da Pozzo LF, Cozzarini C, Briganti A, Suardi N, Salonia A, Bertini R, Gallina A, Bianchi M, Fantini GV, Bolognesi A, Fazio F, Montorsi F, Rigatti P. Long-Term Follow-up of Patients with Prostate Cancer and Nodal Metastases Treated by Pelvic Lymphadenectomy and Radical Prostatectomy: The Positive Impact of Adjuvant Radiotherapy. Eur Urol 2009; 55:1003-11. [DOI: 10.1016/j.eururo.2009.01.046] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Accepted: 01/26/2009] [Indexed: 10/21/2022]
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Briganti A, Suardi N, Gallina A, Da Pozzo LF, Frschi M, Tutolo M, Bianchi M, Passoni N, Rigatti P, Montorsi F. IMPACT OF STAGE MIGRATION ON THE PREVALENCE OF PELVIC LYMPH NODE METASTASES IN PATIENTS UNDERGOING EXTENDED PELVIC LYMPH NODE DISSECTION FOR PROSTATE CANCER: A 23-YEAR SINGLE INSTITUTION EXPERIENCE. J Urol 2009. [DOI: 10.1016/s0022-5347(09)60824-7] [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: 11/25/2022]
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Capitanio U, Isbarn H, Shariat SF, Jeldres C, Zini L, Briganti A, Suardi N, Gallina A, Da Pozzo LF, Montorsi F, Karakiewicz PI. PARTIAL CYSTECTOMY DOES NOT UNDERMINE CANCER CONTROL IN APPROPRIATELY SELECTED PATIENTS WITH UROTHELIAL CARCINOMA OF THE BLADDER: A POPULATION-BASED MATCHED ANALYSIS. J Urol 2009. [DOI: 10.1016/s0022-5347(09)60361-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Suardi N, Briganti A, Gallina A, Da Pozzo LF, Tutolo M, Bianchi M, Capitanio U, Karakiewicz PI. WHICH ARE THE PATIENTS AT RISK TO RECUR BEYOND 10 YEARS AFTER RADICAL PROSTATECTOMY? J Urol 2009. [DOI: 10.1016/s0022-5347(09)61295-7] [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: 11/28/2022]
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Briganti A, Suardi N, Gallina A, Da Pozzo LF, Roscigno M, Freschi M, Cestari A, Guazzoni G, Rigatti P, Montorsi F. WHICH PATIENTS ARE AT REAL HIGH RISK FOR DYING FROM PROSTATE CANCER? A LONG-TERM FOLLOW-UP ANALYSIS ON HIGH RISK PROSTATE CANCER PATIENTS TREATED IN THE PSA ERA. J Urol 2009. [DOI: 10.1016/s0022-5347(09)60770-9] [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: 10/21/2022]
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Roscigno M, Bertini R, Strada E, Petralia G, Sozzi F, Matloob R, Volpe A, Terrone C, Da Pozzo LF, Montorsi F, Rigatti P. IMPACT OF LYMPH NODE DENSITY ON CANCER-SPECIFIC SURVIVAL IN PATIENTS WITH NODE-POSITIVE RENAL CELL CARCINOMA. J Urol 2009. [DOI: 10.1016/s0022-5347(09)60713-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Salonia A, Gallina A, Briganti A, Da Pozzo LF, Colombo R, Zanni G, Dehò F, Rocchini L, Cestari A, Guazzoni G, Rigatti P, Montorsi F. POST-OPERATIVE ORGASMIC FUNCTION INCREASES OVER TIME IN PATIENTS SUBMITTED TO BILATERAL NERVE SPARING OPEN RADICAL PROSTATECTOMY. J Urol 2009. [DOI: 10.1016/s0022-5347(09)60935-6] [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: 11/17/2022]
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Salonia A, Ferrari M, Rocchini L, Gallina A, Matloob R, Saccà A, Zanni G, Colombo R, Suardi N, Da Pozzo LF, Rigatti P, Montorsi F. PREDICTORS OF FERTILITY IN PATIENTS TREATED FOR GERM-CELL TESTICULAR CANCER. J Urol 2009. [DOI: 10.1016/s0022-5347(09)62195-9] [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: 11/24/2022]
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Bertini R, Roscigno M, Angiollilli D, Strada E, Petralia G, Matloob R, Sozzi F, Suardi N, Montorsi F, Da Pozzo LF, Rigatti P. RENAL FUNCTION AND PATIENT SURVIVAL AFTER NEPHRON-SPARING SURGERY FOR RENAL CELL CARCINOMA. J Urol 2009. [DOI: 10.1016/s0022-5347(09)60617-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Briganti A, Gallina A, Suardi N, Chun FKH, Bianchi M, Abdollah F, Salonia A, Da Pozzo LF, DiGirolamo V, Karakiewicz PI, Rigatti P, Montorsi F. DEVELOPMENT AND SPLIT SAMPLE VALIDATION OF AN UPDATED NOMOGRAM PREDICTING THE PROBABILITY OF LYMPH NODE INVASION IN PATIENTS WITH CLINICALLY LOCALIZED PROSTATE CANCER UNDERGOING EXTENDED PELVIC LYMPH NODE DISSECTION. J Urol 2009. [DOI: 10.1016/s0022-5347(09)62110-8] [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: 11/29/2022]
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Briganti A, Capitanio U, Chun FKH, Gallina A, Suardi N, Salonia A, Da Pozzo LF, Colombo R, Di Girolamo V, Bertini R, Guazzoni G, Karakiewicz PI, Montorsi F, Rigatti P. Impact of Surgical Volume on the Rate of Lymph Node Metastases in Patients Undergoing Radical Prostatectomy and Extended Pelvic Lymph Node Dissection for Clinically Localized Prostate Cancer. Eur Urol 2008; 54:794-802. [DOI: 10.1016/j.eururo.2008.05.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2008] [Accepted: 05/07/2008] [Indexed: 11/26/2022]
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Volkmer BG, Colombo R, Briganti A, Kuefer R, Da Pozzo LF, Bartsch G, Moeller P, Freschi M, Rigatti P, Hautmann RE, Montorsi F. DEVELOPMENT AND INTERNAL VALIDATION OF A NOVEL NOMOGRAM PREDICTING BLADDER CANCER SPECIFIC SURVIVAL OF PATIENTS WITH PT0 DISEASE FOLLOWING RADICAL CYSTECTOMY. RESULTS FROM A TWO INSTITUTION SERIES. J Urol 2008. [DOI: 10.1016/s0022-5347(08)61611-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Briganti A, Karnes RJ, Da Pozzo LF, Cozzarini C, Bianchi M, Capitanio U, Gallina A, Salonia A, Chun FKH, Karakiewicz PI, Fazio F, Montorsi F, Rigatti P, Blute ML. DEVELOPMENT AND INTERNAL VALIDATION OF THE FIRST NOMOGRAM PREDICTING LONG-TERM PROSTATE CANCER SPECIFIC SURVIVAL IN PATIENTS WITH NODE POSITIVE PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY AND PELVIC LYMPH NODE DISSECTION. J Urol 2008. [DOI: 10.1016/s0022-5347(08)60725-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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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Da Pozzo LF, Briganti A, Cozzarini C, Salonia A, Bianchi M, Chun FKH, Freschi M, Suardi N, Karakiewicz PI, Huland H, Fazio F, Rigatti P, Montorsi F. FACTORS PREDICTING DISEASE FREE SURVIVAL IN PATIENTS WITH NODE POSITIVE PROSTATE CANCER TREATED WITH RADICAL PROSTATECTOMY AND EXTENDED PELVIC LYMPH NODE DISSECTION IN THE PSA ERA: ROLE OF ADJUVANT RADIOTHERAPY. J Urol 2008. [DOI: 10.1016/s0022-5347(08)60536-4] [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: 11/26/2022]
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Bhojani N, Jeldres C, Da Pozzo LF, Morgan M, Shariat SF, Perrotte P, Suardi N, Saad F, Montorsi F, Karakiewicz PI. EXTERNAL-BEAM RADIATION THERAPY INCREASES THE RATE OF SECONDARY MALIGNANCIES RELATIVE TO RADICAL PROSTATECTOMY IN MEN WITH PROSTATE CANCER. J Urol 2008. [DOI: 10.1016/s0022-5347(08)60326-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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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Da Pozzo LF. Editorial comment on: The feasibility of prostate cancer detection by triple spectroscopy. Eur Urol 2008; 55:383-4. [PMID: 18359149 DOI: 10.1016/j.eururo.2008.02.023] [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: 10/22/2022]
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Briganti A, Pellucchi F, Da Pozzo LF, Freschi M, Salonia A, Chun FKH, Bocciardi AM, Di Girolamo V, Camerata TC, Capitanio U, Roscigno M, Karakiewicz PI, Rigatti P, Montorsi F. 722: Pathological Characteristics and Stage Migration of Patients with Prostate Cancer and Lymph Node Invasion Undergoing an Extended Pelvic Lymph Node Dissection at a Single Institution Over a 15 Year Period. J Urol 2007. [DOI: 10.1016/s0022-5347(18)30962-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Briganti A, Da Pozzo LF, Pellucchi F, Cozzarini C, Chun FKH, Strada E, Petralia G, Camerata TC, Gallina A, Benedusi F, Bocciardi AM, Salonia A, Karakiewicz PI, Rigatti P, Montorsi F. 724: Excellent Long-Term Outcome of Patients with Low Volume of Lymph Node Invasion Treated with Extended Pelvic Lymph Node Dissection at the time of Radical Prostatectomy. J Urol 2007. [DOI: 10.1016/s0022-5347(18)30964-9] [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: 10/17/2022]
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Roscigno M, Cozzarini C, Bertini R, Scattoni V, Pastal A, Mazzoccoli B, Capitanio U, Da Pozzo LF, Colombo R, Montorsi F, Rigatti P. 408: Prognostic Value of Lymphnode Dissection in Patients with Muscle-Invasive Transitional Cell Carcinoma of the Upper Urinary Tract. J Urol 2007. [DOI: 10.1016/s0022-5347(18)30661-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Suardi N, Strada E, Colombo R, Freschi M, Scattoni V, Salonia A, Da Pozzo LF, Briganti A, Raber M, Sozzi F, Bocciardi AM, Rigatti P, Montorsi F. 1215: Leydig Cell Tumour of the Testis: Presentation, Therapy and Impact of Surgery on Symptomatic Features. J Urol 2007. [DOI: 10.1016/s0022-5347(18)31429-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bertini R, Roscigno M, Cozzarini C, Pasta A, Sangalli M, Petralia G, Strada E, Bocciardi AM, Da Pozzo LF, Colombo R, Rigatti P. 1119: Renal Cell Carcinoma with Tumor Thrombosis: Prognostic Role of Concomitant Perinephric Fat Invasion. J Urol 2007. [DOI: 10.1016/s0022-5347(18)31333-8] [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: 11/26/2022]
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Haese A, Gallina A, Walz J, Weber D, Heinzer H, Klein EA, Reuther AM, Eastham JA, Da Pozzo LF, Montorsi F, Graefen M, Huland H, Saad F, Karakiewicz PI. 321: No Differences in Biochemical Recurrence between NO and NX Patients Subjected to Radical Prostatectomy: A Matched Analyses on 5977 Patients. J Urol 2007. [DOI: 10.1016/s0022-5347(18)30586-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Walz J, Gallina A, Chun FKH, Da Pozzo LF, Reuther AM, Eastham JA, Klein EA, Scardino PT, Graefen M, Huland H, Karakiewicz PI. 729: A Risk Adjusted Follow Up Scheme after Radical Prostatectomy for Prostate Cancer. J Urol 2007. [DOI: 10.1016/s0022-5347(18)30969-8] [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: 11/30/2022]
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Briganti A, Chun FKH, Salonia A, Gallina A, Farina E, Da Pozzo LF, Rigatti P, Montorsi F, Karakiewicz PI. Validation of a nomogram predicting the probability of lymph node invasion based on the extent of pelvic lymphadenectomy in patients with clinically localized prostate cancer. BJU Int 2006; 98:788-93. [PMID: 16796698 DOI: 10.1111/j.1464-410x.2006.06318.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To develop a multivariate nomogram to predict the rate of lymph node invasion (LNI) in patients with clinically localized prostate cancer according to the extent of extended pelvic lymphadenectomy (PLND), which is associated with significantly higher rate of LNI. PATIENTS AND METHODS The study comprised 781 consecutive patients (median age 66.6 years, range 45-85) treated with PLND and radical retropubic prostatectomy (RRP) for clinically localized prostate cancer. Their median (range) prostate-specific antigen (PSA) level was 7 (1.03-49.91) ng/mL, and their clinical stages were T1c in 433 (55.4%), T2 in 328 (42%) and T3 in 20 (2.6%). Biopsy Gleason sums were <or= 6 in 514 (65.8%), 7 in 204 (26.1%) and 8-10 in 63 (8.1%). Multivariate logistic regression models were used to test the association between predictors including PSA level, biopsy Gleason sum, clinical stage, number of nodes removed and the rate of LNI. Finally, regression coefficients were used to develop a nomogram, which was internally validated with 200 bootstrap re-samples. RESULTS The median (range) number of lymph nodes removed was 14 (2-40); LNI was detected in 71 patients (9.1%). The univariate predictive accuracy for total PSA level, clinical stage, biopsy Gleason sum and number of total nodes removed and examined was 64.2%, 59.8%, 74% and 62.9%, respectively. Except for PSA (P = 0.2), all variables were statistically significant multivariate predictors of LNI at RRP (P <or= 0.001). A nomogram based on clinical stage, PSA level, biopsy Gleason sum and the number of total lymph nodes removed was 78.6% accurate, and 1.8% more accurate than a nomogram without the number of removed lymph nodes. CONCLUSIONS The extent of PLND is directly related to the probability of LNI. The risk of LNI increases linearly, and is proportional to the number of nodes removed and examined. The effect of the increased probability of LNI is weighted more heavily in men with more advanced clinical stage and grade.
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Salonia A, Crescenti A, Suardi N, Memmo A, Naspro R, Bocciardi AM, Colombo R, Da Pozzo LF, Rigatti P, Montorsi F. General versus spinal anesthesia in patients undergoing radical retropubic prostatectomy: results of a prospective, randomized study. Urology 2004; 64:95-100. [PMID: 15245943 DOI: 10.1016/j.urology.2004.03.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [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: 12/01/2003] [Accepted: 03/05/2004] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To evaluate the impact of general anesthesia (GA) versus spinal anesthesia (SpA) on intraoperative and postoperative outcome in patients undergoing radical retropubic prostatectomy. METHODS Seventy-two consecutive patients with clinically localized prostate cancer were randomized into group 1 (GA: 34 patients) or group 2 (L2-L3 or L3-L4 SpA: 38 patients) and underwent radical retropubic prostatectomy. The intraoperative and postoperative anesthetic and surgical variables were evaluated. RESULTS The mean +/- SEM operative time was not significantly different between the two groups (P = 0.43). The overall blood loss was less in group 2 (P = 0.04). The mean +/- SEM postoperative time in the postoperative holding area was significantly shorter after SpA than after GA (P <0.0001). The perioperative pain outcome in the postoperative holding area was significantly better for group 2 than for group 1 (P = 0.0017), but postoperative pain on day 1 was not significantly different between the two groups. The postoperative sedation score was significantly less in group 2 than in group 1 (P <0.0001). On day 1, first flatus passed in a significantly larger number of patients in group 2 (P <0.0001), and the overall gait was greater for group 2 patients (P = 0.02). CONCLUSIONS These results suggest that SpA allows good muscle relaxation and a successful surgical outcome in patients undergoing radical retropubic prostatectomy with pelvic lymphadenectomy for clinically localized prostate cancer. Moreover, SpA results in less intraoperative blood loss, less postoperative pain, and a faster postoperative recovery than GA.
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Affiliation(s)
- Andrea Salonia
- Department ofUrology, University Vita-Salute San Raffaele, Scientific Institute H. San Raffaele, Milan, Italy
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Montorsi F, Salonia A, Centemero A, Guazzoni G, Nava L, Da Pozzo LF, Cestari A, Colombo R, Barbagli G, Rigatti P. Vestibular flap urethroplasty for strictures of the female urethra. Impact on symptoms and flow patterns. Urol Int 2003; 69:12-6. [PMID: 12119432 DOI: 10.1159/000064353] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To assess the impact on subjective symptoms and flow patterns of a new surgical technique designed to correct strictures of the female distal urethra and urethral meatus. MATERIALS AND METHODS Seventeen patients (mean age 41.2 years) with symptomatic strictures of either the distal urethra or the urethral meatus entered the study. Patients reporting an AUA score >20, a diagnosis of bladder outlet obstruction according to the Abrams-Griffiths nomogram and the Schaefer linPURR diagram, urethral calibration <20 F and radiologic evidence of the stricture, were considered eligible for surgery. A pedicled flap isolated from the vaginal vestibule was anastomosed with two longitudinal running sutures along the two edges of an opened urethra. RESULTS In all cases, diffuse fibrosis of the urethral wall was demonstrated at histological examination. Mean (+/- SE) preoperative and 12-month follow-up results were as follows: AUA score 25.2 +/- 2.1 vs. 8.4 +/- 1.2 (p < 0.0001); peak flow rate (ml/s) 13.2 +/- 1.2 vs. 36 +/- 1.5 (p < 0.0001); detrusor pressure at Q(max) (cm H(2)O) 45 +/- 5 vs. 17 +/- 3; residual urine volume (ml) 120 +/- 5 vs. 20 +/- 5 (p < 0.0001). Fifteen patients (88%) showed an unobstructed Abrams-Griffiths nomogram and a Schaefer linPURR diagram postoperatively. All but 2 cases (88%) could be calibrated at 28 F postoperatively and showed a normal urethral lumen at voiding cystourethrography. Complications were never noted. CONCLUSIONS Female patients with symptomatic strictures of the distal urethra or urethral meatus may be treated efficaciously and safely with vestibular flap urethroplasty. Although this technique must be performed under optical magnification it is easy to perform and is not associated with complications.
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Affiliation(s)
- Francesco Montorsi
- Department of Urology, University Vita e Salute, Scientific Institute Hospital San Raffaele, Milan, Italy.
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Montorsi F, Luigi GG, Strambi LF, Da Pozzo LF, Nava L, Barbieri L, Rigatti P, Pizzini G, Miani A. RECOVERY OF SPONTANEOUS ERECTILE FUNCTION AFTER NERVE-SPARING RADICAL RETROPUBIC PROSTATECTOMY WITH AND WITHOUT EARLY INTRACAVERNOUS INJECTIONS OF ALPROSTADIL: RESULTS OF A PROSPECTIVE, RANDOMIZED TRIAL. J Urol 1997. [DOI: 10.1016/s0022-5347(01)64227-7] [Citation(s) in RCA: 218] [Impact Index Per Article: 8.1] [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)
- Francesco Montorsi
- From the Institute of Human Anatomy, University of Milan School of Medicine and Divisions of Urology and Neurology, Scientific Institute H. San Raffaele, Milan, Italy
| | - Giorgio Guazzoni Luigi
- From the Institute of Human Anatomy, University of Milan School of Medicine and Divisions of Urology and Neurology, Scientific Institute H. San Raffaele, Milan, Italy
| | - Luigi Ferini Strambi
- From the Institute of Human Anatomy, University of Milan School of Medicine and Divisions of Urology and Neurology, Scientific Institute H. San Raffaele, Milan, Italy
| | - Luigi F. Da Pozzo
- From the Institute of Human Anatomy, University of Milan School of Medicine and Divisions of Urology and Neurology, Scientific Institute H. San Raffaele, Milan, Italy
| | - Luciano Nava
- From the Institute of Human Anatomy, University of Milan School of Medicine and Divisions of Urology and Neurology, Scientific Institute H. San Raffaele, Milan, Italy
| | - Luigi Barbieri
- From the Institute of Human Anatomy, University of Milan School of Medicine and Divisions of Urology and Neurology, Scientific Institute H. San Raffaele, Milan, Italy
| | - Patrizio Rigatti
- From the Institute of Human Anatomy, University of Milan School of Medicine and Divisions of Urology and Neurology, Scientific Institute H. San Raffaele, Milan, Italy
| | - Giuliano Pizzini
- From the Institute of Human Anatomy, University of Milan School of Medicine and Divisions of Urology and Neurology, Scientific Institute H. San Raffaele, Milan, Italy
| | - Alberto Miani
- From the Institute of Human Anatomy, University of Milan School of Medicine and Divisions of Urology and Neurology, Scientific Institute H. San Raffaele, Milan, Italy
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Scattoni V, Da Pozzo LF, Colombo R, Nava L, Rigatti P, De Cobelli F, Vanzulli A, Del Maschio A. Dynamic Gadolinium-Enhanced Magnetic Resonance Imaging in Staging of Superficial Bladder Cancer. J Urol 1996. [DOI: 10.1016/s0022-5347(01)66139-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Vincenzo Scattoni
- Departments of Urology and Radiology, Scientific Institute H San Raffaele, Milan, Italy
| | - Luigi F. Da Pozzo
- Departments of Urology and Radiology, Scientific Institute H San Raffaele, Milan, Italy
| | - Renzo Colombo
- Departments of Urology and Radiology, Scientific Institute H San Raffaele, Milan, Italy
| | - Luciano Nava
- Departments of Urology and Radiology, Scientific Institute H San Raffaele, Milan, Italy
| | - Patrizio Rigatti
- Departments of Urology and Radiology, Scientific Institute H San Raffaele, Milan, Italy
| | - Francesco De Cobelli
- Departments of Urology and Radiology, Scientific Institute H San Raffaele, Milan, Italy
| | - Angelo Vanzulli
- Departments of Urology and Radiology, Scientific Institute H San Raffaele, Milan, Italy
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Colombo R, Da Pozzo LF, Lev A, Freschi M, Gallus G, Rigatti P. Neoadjuvant Combined Microwave Induced Local Hyperthermia and Topical Chemotherapy Versus Chemotherapy Alone for Superficial Bladder Cancer. J Urol 1996. [DOI: 10.1016/s0022-5347(01)66225-6] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Renzo Colombo
- Departments of Urology (Projecting and Development Unit) and Pathology (Biomedical Statistics Unit), Scientific Institute H. San Raffaele, Milan, Italy
| | - Luigi F. Da Pozzo
- Departments of Urology (Projecting and Development Unit) and Pathology (Biomedical Statistics Unit), Scientific Institute H. San Raffaele, Milan, Italy
| | - Avigdor Lev
- Departments of Urology (Projecting and Development Unit) and Pathology (Biomedical Statistics Unit), Scientific Institute H. San Raffaele, Milan, Italy
| | - Massimo Freschi
- Departments of Urology (Projecting and Development Unit) and Pathology (Biomedical Statistics Unit), Scientific Institute H. San Raffaele, Milan, Italy
| | - Giuseppe Gallus
- Departments of Urology (Projecting and Development Unit) and Pathology (Biomedical Statistics Unit), Scientific Institute H. San Raffaele, Milan, Italy
| | - Patrizio Rigatti
- Departments of Urology (Projecting and Development Unit) and Pathology (Biomedical Statistics Unit), Scientific Institute H. San Raffaele, Milan, Italy
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Colombo R, Lev A, Da Pozzo LF, Freschi M, Gallus G, Rigatti P. Original Articles: Bladder Cancer: A New Approach Using Local Combined Microwave Hyperthermia and Chemotherapy in Superficial Transitional Bladder Carcinoma Treatment. J Urol 1995. [DOI: 10.1016/s0022-5347(01)67613-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Renzo Colombo
- From the Department of Urology, Projecting and Development Unit, Department of Pathology and Biomedical Statistics, Scientific Institute H. S. Raffaele, Milan, Italy
| | - Avigdor Lev
- From the Department of Urology, Projecting and Development Unit, Department of Pathology and Biomedical Statistics, Scientific Institute H. S. Raffaele, Milan, Italy
| | - Luigi F. Da Pozzo
- From the Department of Urology, Projecting and Development Unit, Department of Pathology and Biomedical Statistics, Scientific Institute H. S. Raffaele, Milan, Italy
| | - Massimo Freschi
- From the Department of Urology, Projecting and Development Unit, Department of Pathology and Biomedical Statistics, Scientific Institute H. S. Raffaele, Milan, Italy
| | - Giuseppe Gallus
- From the Department of Urology, Projecting and Development Unit, Department of Pathology and Biomedical Statistics, Scientific Institute H. S. Raffaele, Milan, Italy
| | - Patrizio. Rigatti
- From the Department of Urology, Projecting and Development Unit, Department of Pathology and Biomedical Statistics, Scientific Institute H. S. Raffaele, Milan, Italy
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