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  1. Article ; Online: Near-infrared fluorescence for minimally invasive management of colovesical fistula.

    Bernardi, D / Asti, E / Acquati, P / Carmignani, L / Bonavina, L

    Annals of the Royal College of Surgeons of England

    2021  Volume 103, Issue 10, Page(s) 777–778

    MeSH term(s) Colon, Sigmoid/diagnostic imaging ; Colon, Sigmoid/pathology ; Colon, Sigmoid/surgery ; Diverticulitis, Colonic/complications ; Fluorescence ; Humans ; Indocyanine Green/administration & dosage ; Intestinal Fistula/diagnosis ; Intestinal Fistula/etiology ; Intestinal Fistula/surgery ; Intraoperative Care/methods ; Intraoperative Complications/etiology ; Intraoperative Complications/prevention & control ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Optical Imaging/methods ; Sigmoid Diseases/complications ; Sigmoid Diseases/diagnosis ; Sigmoid Diseases/surgery ; Treatment Outcome ; Ureter/diagnostic imaging ; Urinary Bladder
    Chemical Substances Indocyanine Green (IX6J1063HV)
    Language English
    Publishing date 2021-11-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 80044-2
    ISSN 1478-7083 ; 0035-8843
    ISSN (online) 1478-7083
    ISSN 0035-8843
    DOI 10.1308/rcsann.2021.0172
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  2. Article ; Online: Stone centers: a national survey on surgical techniques performed in Italy.

    DI Bari, Stefano / Stella, Giuseppe / Benedetti, Mattia / Talso, Michele / Saita, Alberto / Zaraca, Carlo / Ferrari, Riccardo / Acquati, Pietro / Lombardo, Riccardo / Ferretti, Stefania / Puliatti, Stefano / Cormio, Luigi / Micali, Salvatore

    Minerva urology and nephrology

    2024  Volume 76, Issue 2, Page(s) 230–234

    Abstract: Background: Recurrent and complex stone disease may be considered a challenging disease. In 2018, the Calculus group of the SIU (Italian Society of Urology) set itself the goal of establishing the minimum requirements for a center that could ... ...

    Abstract Background: Recurrent and complex stone disease may be considered a challenging disease. In 2018, the Calculus group of the SIU (Italian Society of Urology) set itself the goal of establishing the minimum requirements for a center that could continuously manage urolithiasis pathology, named a Stone Center. In this study we present the results of a pilot survey carried out in 2019 with the aim of drawing a map of the situation of Italian urological centers dealing with urinary stones.
    Methods: A total of 260 national urology departments dealing with urolithiasis surgery were contacted for this study. A survey was issued to each of the centers to determine the number of patients treated for urinary stones and the amount of procedures performed per year: 1) extracorporeal shock wave lithotripsy ESWL; 2) ureterorenoscopy URS; 3) retrograde intrarenal surgery RIRS; 4) percutaneous nephrolithotomy PCNL.
    Results: Out of 260 centers contacted, 188 fulfilled the survey. Outcomes were quite variable, with approximately 37% of the centers lacking a lithotripter, and 46% of those that did have it performing fewer than 100 treatments per year. In terms of endoscopic procedures, more than 80% of the centers contacted performed URS or RIRS; however, when it came to percutaneous lithotripsy, these numbers dropped significantly; 33% of the centers contacted did not perform PCNL, and of those who did, 18% had less than 5 years of experience as a center.
    Conclusions: Our survey shows a very heterogeneous national picture about urolithiasis treatments. Our goal is to create national paradigms to be able to define stone centers where the patient suffering from complex urinary stones can find a network of professionals with an adequate armamentarium suitable for the management of their pathology.
    MeSH term(s) Humans ; Italy/epidemiology ; Urinary Calculi/surgery ; Urinary Calculi/therapy ; Urologic Surgical Procedures/statistics & numerical data ; Urologic Surgical Procedures/methods ; Lithotripsy/methods ; Lithotripsy/statistics & numerical data ; Urolithiasis/surgery ; Urolithiasis/therapy ; Pilot Projects ; Health Care Surveys ; Surveys and Questionnaires ; Nephrolithotomy, Percutaneous/methods
    Language English
    Publishing date 2024-05-14
    Publishing country Italy
    Document type Journal Article ; Multicenter Study
    ZDB-ID 3062840-4
    ISSN 2724-6442
    ISSN (online) 2724-6442
    DOI 10.23736/S2724-6051.24.05778-1
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  3. Article ; Online: Ureteral stricture rate after endoscopic treatments for urolithiasis and related risk factors: systematic review and meta-analysis.

    Moretto, S / Saita, A / Scoffone, C M / Talso, M / Somani, B K / Traxer, O / Angerri, O / Knoll, T / Liatsikos, E / Herrmann, T R W / Ulvik, Ø / Skolarikos, A / Cracco, C M / Keller, E X / Paciotti, M / Piccolini, A / Uleri, A / Tailly, T / Carmignani, L /
    Pietropaolo, A / Corrales, M / Lughezzani, G / Lazzeri, M / Fasulo, V / De Coninck, V / Arena, P / Nagele, U / Ferretti, S / Kronenberg, P / Perez-Fentes, D / Osther, P J / Goumas, I K / Acquati, P / Ajayi, L / Diana, P / Casale, P / Buffi, N M

    World journal of urology

    2024  Volume 42, Issue 1, Page(s) 234

    Abstract: Purpose: We aimed to accurately determine ureteral stricture (US) rates following urolithiasis treatments and their related risk factors.: Methods: We conducted a systematic review and meta-analysis following the PRISMA guidelines using databases ... ...

    Abstract Purpose: We aimed to accurately determine ureteral stricture (US) rates following urolithiasis treatments and their related risk factors.
    Methods: We conducted a systematic review and meta-analysis following the PRISMA guidelines using databases from inception to November 2023. Studies were deemed eligible for analysis if they included ≥ 18 years old patients with urinary lithiasis (Patients) who were subjected to endoscopic treatment (Intervention) with ureteroscopy (URS), percutaneous nephrolithotomy (PCNL), or shock wave lithotripsy (SWL) (Comparator) to assess the incidence of US (Outcome) in prospective and retrospective studies (Study design).
    Results: A total of 43 studies were included. The pooled US rate was 1.3% post-SWL and 2.1% post-PCNL. The pooled rate of US post-URS was 1.9% but raised to 2.7% considering the last five years' studies and 4.9% if the stone was impacted. Moreover, the pooled US rate differed if follow-ups were under or over six months. Patients with proximal ureteral stone, preoperative hydronephrosis, intraoperative ureteral perforation, and impacted stones showed higher US risk post-endoscopic intervention with odds ratio of 1.6 (P = 0.05), 2.6 (P = 0.009), 7.1 (P < 0.001), and 7.47 (P = 0.003), respectively.
    Conclusions: The overall US rate ranges from 0.3 to 4.9%, with an increasing trend in the last few years. It is influenced by type of treatment, stone location and impaction, preoperative hydronephrosis and intraoperative perforation. Future standardized reporting and prospective and more extended follow-up studies might contribute to a better understanding of US risks related to calculi treatment.
    MeSH term(s) Humans ; Adolescent ; Constriction, Pathologic ; Prospective Studies ; Retrospective Studies ; Urolithiasis/surgery ; Ureteroscopy/adverse effects ; Ureteral Calculi/surgery ; Hydronephrosis
    Language English
    Publishing date 2024-04-13
    Publishing country Germany
    Document type Meta-Analysis ; Systematic Review ; Journal Article ; Review
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-024-04933-2
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  4. Article ; Online: Other-cause mortality in incidental prostate cancer.

    Di Bello, Francesco / Baudo, Andrea / de Angelis, Mario / Jannello, Letizia Maria Ippolita / Siech, Carolin / Tian, Zhe / Goyal, Jordan A / Collà Ruvolo, Claudia / Califano, Gianluigi / La Rocca, Roberto / Morra, Simone / Acquati, Pietro / Saad, Fred / Shariat, Shahrokh F / Carmignani, Luca / de Cobelli, Ottavio / Briganti, Alberto / Chun, Felix K H / Longo, Nicola /
    Karakiewicz, Pierre I

    The Prostate

    2024  Volume 84, Issue 8, Page(s) 731–737

    Abstract: Background: In incidental prostate cancer (IPCa), elevated other-cause mortality (OCM) may obviate the need for active treatment. We tested OCM rates in IPCa according to treatment type and cancer grade and we hypothesized that OCM is significantly ... ...

    Abstract Background: In incidental prostate cancer (IPCa), elevated other-cause mortality (OCM) may obviate the need for active treatment. We tested OCM rates in IPCa according to treatment type and cancer grade and we hypothesized that OCM is significantly higher in not-actively-treated patients.
    Methods: Within the Surveillance, Epidemiology, and End Results database (2004-2015), IPCa patients were identified. Smoothed cumulative incidence plots as well as multivariable competing risks regression models were fitted to address OCM after adjustment for cancer-specific mortality (CSM).
    Results: Of 5121 IPCa patients, 3655 (71%) were not-actively-treated while 1466 (29%) were actively-treated. Incidental PCa not-actively-treated patients were older and exhibited higher proportion of Gleason sum (GS) 6 and clinical T1a stage. In smoothed cumulative incidence plots, 5-year OCM was 20% for not-actively-treated versus 8% for actively-treated patients. Conversely, 5-year CSM was 5% for not-actively-treated versus 4% for actively-treated patients. No active treatment was associated with 1.4-fold higher OCM, even after adjustment for age, cancer characteristics, and CSM. According to GS, OCM reached 16%, 27%, and 35% in GS 6, 7, and 8-10 not-actively-treated IPCa patients, respectively and exceeded CSM recorded for the same three groups (2%, 6%, and 28%, respectively).
    Conclusion: Our results quantified OCM rates, confirming that in not-actively-treated IPCa patients OCM is indeed significantly higher than in their actively-treated counterparts (HR: 1.4). These observations validate the use of no active treatment in IPCa patients, in whom OCM greatly surpasses CSM (20% vs. 5%).
    MeSH term(s) Humans ; Male ; Prostatic Neoplasms/mortality ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/drug therapy ; Aged ; Middle Aged ; SEER Program ; Incidental Findings ; Cause of Death ; Neoplasm Grading ; Aged, 80 and over ; United States/epidemiology ; Incidence
    Language English
    Publishing date 2024-03-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604707-5
    ISSN 1097-0045 ; 0270-4137
    ISSN (online) 1097-0045
    ISSN 0270-4137
    DOI 10.1002/pros.24689
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  5. Article ; Online: Surgically treated pelvic liposarcoma and leiomyosarcoma: The effect of tumor size on cancer-specific survival.

    Baudo, Andrea / Piccinelli, Mattia Luca / Incesu, Reha-Baris / Morra, Simone / Scheipner, Lukas / Barletta, Francesco / Tappero, Stefano / Garcia, Cristina Cano / Assad, Anis / Tian, Zhe / Acquati, Pietro / de Cobelli, Ottavio / Longo, Nicola / Briganti, Alberto / Terrone, Carlo / Chun, Felix K H / Tilki, Derya / Ahyai, Sascha / Saad, Fred /
    Shariat, Shahrokh F / Carmignani, Luca / Karakiewicz, Pierre I

    Surgical oncology

    2024  Volume 54, Page(s) 102074

    Abstract: Introduction: In soft tissue pelvic liposarcoma and leiomyosarcoma, it is unknown whether a specific tumor size cut-off may help to better predict prognosis, defined as cancer-specific survival (CSS). We tested whether different tumor size cut-offs, ... ...

    Abstract Introduction: In soft tissue pelvic liposarcoma and leiomyosarcoma, it is unknown whether a specific tumor size cut-off may help to better predict prognosis, defined as cancer-specific survival (CSS). We tested whether different tumor size cut-offs, could improve CSS prediction.
    Materials and methods: Surgically treated non-metastatic soft tissue pelvic sarcoma patients were identified (Surveillance, Epidemiology, and End Results 2004-2019). Kaplan-Meier plots, univariable and multivariable Cox-regression models and receiver operating characteristic-derived area under the curve (AUC) estimates were used.
    Results: Overall, 672 (65 %) liposarcoma (median tumor size 11 cm, interquartile range [IQR] 7-16) and 367 (35 %) leiomyosarcoma (median tumor size 8 cm, IQR 5-12) patients were identified. The p-value derived ideal tumor size cut-off was 17.1 cm, in liposarcoma and 7.0 cm, in leiomyosarcoma. In liposarcoma, according to p-value derived cut-off, five-year CSS rates were 92 vs 83 % (≤17.1 vs > 17.1 cm). This cut-off represented an independent predictor of CSS and improved prognostic ability from 83.8 to 86.8 % (Δ = 3 %). Similarly, among previously established cut-offs (5 vs 10 vs 15 cm), also 15 cm represented an independent predictor of CSS and improved prognostic ability from 83.8 to 87.0 % (Δ = 3.2 %). In leiomyosarcoma, according to p-value derived cut-off, five-year CSS rates were 86 vs 55 % (≤7.0 vs > 7.0 cm). This cut-off represented an independent predictor of CSS and improved prognostic ability from 68.6 to 76.5 % (Δ = 7.9 %).
    Conclusions: In liposarcoma, the p-value derived tumor size cut-off was 17.1 cm vs 7.0 cm, in leiomyosarcoma. In both histologic subtypes, these cut-offs exhibited the optimal statistical characteristics (univariable, multivariable and AUC analyses). In liposarcoma, the 15 cm cut-off represented a valuable alternative.
    Language English
    Publishing date 2024-04-09
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 1107810-8
    ISSN 1879-3320 ; 0960-7404
    ISSN (online) 1879-3320
    ISSN 0960-7404
    DOI 10.1016/j.suronc.2024.102074
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    Zs.A 3409: Show issues Location:
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  6. Article ; Online: The effect of married status on cancer-specific mortality in nonmetastatic pelvic liposarcoma patients according to sex.

    Baudo, Andrea / Morra, Simone / Scheipner, Lukas / Jannello, Letizia Maria Ippolita / de Angelis, Mario / Siech, Carolin / Touma, Nawar / Goyal, Jordan A / Tian, Zhe / Acquati, Pietro / Longo, Nicola / Ahyai, Sascha / de Cobelli, Ottavio / Briganti, Alberto / Chun, Felix K H / Saad, Fred / Shariat, Shahrokh F / Carmignani, Luca / Karakiewicz, Pierre I

    World journal of surgery

    2023  Volume 48, Issue 1, Page(s) 97–103

    Abstract: Background: In nonmetastatic pelvic liposarcoma patients, it is unknown whether married status is associated with better cancer-control outcome defined as cancer-specific mortality (CSM). We addressed this knowledge gap and hypothesized that married ... ...

    Abstract Background: In nonmetastatic pelvic liposarcoma patients, it is unknown whether married status is associated with better cancer-control outcome defined as cancer-specific mortality (CSM). We addressed this knowledge gap and hypothesized that married status is associated with lower CSM rates in both male and female patients.
    Methods: Within the Surveillance, Epidemiology, and End Results database (2000-2020), nonmetastatic pelvic liposarcoma patients were identified. Kaplan-Meier plots and univariable and multivariable Cox regression models (CRMs) predicting CSM according to marital status were used in the overall cohort and in male and female subgroups.
    Results: Of 1078 liposarcoma patients, 764 (71%) were male and 314 (29%) female. Of 764 male patients, 542 (71%) were married. Conversely, of 314 female patients, 192 (61%) were married. In the overall cohort, 5-year cancer-specific mortality-free survival (CSM-FS) rates were 89% for married versus 83% for unmarried patients (Δ = 6%). In multivariable CRMs, married status did not independently predict lower CSM (hazard ratio [HR]: 0.74, p = 0.06). In males, 5-year CSM-FS rates were 89% for married versus 86% for unmarried patients (Δ = 3%). In multivariable CRMs, married status did not independently predict lower CSM (HR: 0.85, p = 0.4). In females, 5-year CSM-FS rates were 88% for married versus 79% for unmarried patients (Δ = 9%). In multivariable CRMs, married status independently predicted lower CSM (HR: 0.58, p = 0.03).
    Conclusions: In nonmetastatic pelvic liposarcoma patients, married status independently predicted lower CSM only in female patients. In consequence, unmarried female patients should ideally require more assistance and more frequent follow-up than their married counterparts.
    MeSH term(s) Humans ; Male ; Liposarcoma/mortality ; Female ; Middle Aged ; Marital Status/statistics & numerical data ; Aged ; Pelvic Neoplasms/mortality ; Sex Factors ; SEER Program ; Adult ; Retrospective Studies
    Language English
    Publishing date 2023-12-18
    Publishing country United States
    Document type Journal Article
    ZDB-ID 224043-9
    ISSN 1432-2323 ; 0364-2313
    ISSN (online) 1432-2323
    ISSN 0364-2313
    DOI 10.1002/wjs.12040
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    Zs.A 1336: Show issues Location:
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  7. Article ; Online: Other-Cause Mortality, According to Partial vs. Radical Nephrectomy: Age and Stage Analyses.

    Baudo, Andrea / Incesu, Reha-Baris / Morra, Simone / Scheipner, Lukas / Jannello, Letizia Maria Ippolita / de Angelis, Mario / Siech, Carolin / Tian, Zhe / Acquati, Pietro / Tilki, Derya / Longo, Nicola / Ahyai, Sascha / de Cobelli, Ottavio / Briganti, Alberto / Chun, Felix K H / Saad, Fred / Shariat, Shahrokh F / Carmignani, Luca / Karakiewicz, Pierre I

    Clinical genitourinary cancer

    2023  Volume 22, Issue 2, Page(s) 181–188

    Abstract: Introduction: We tested the association between other-cause mortality and partial vs. radical nephrectomy in patients with T1a, T1b, and T2 renal cell carcinoma, across all patient ages.: Material and methods: Within the Surveillance, Epidemiology, ... ...

    Abstract Introduction: We tested the association between other-cause mortality and partial vs. radical nephrectomy in patients with T1a, T1b, and T2 renal cell carcinoma, across all patient ages.
    Material and methods: Within the Surveillance, Epidemiology, and End Results database (2010-2020), patients with localized renal cell carcinoma stages (T1a-T1b-T2, N0, M0), who underwent partial or radical nephrectomy were identified. Only patients with tumor size 2 to 10 cm were included. Cumulative incidence plots and multivariable competing risks regression models were used.
    Results: Of 68,195 patients, 28,845 (42%) underwent partial nephrectomy vs. 39,350 (58%) radical nephrectomy. In T1a patients, 5-year other-cause mortality rates were 6% for partial nephrectomy vs. 11% for radical nephrectomy (Δ=5%). In T1a patients, partial nephrectomy independently predicted lower other-cause mortality, across all ages (HR: 0.73, P < .001). In age category subgroup analyses addressing T1a patients, in all age categories, partial nephrectomy invariably predicted lower other-cause mortality than radical nephrectomy: ≤59 years (HR: 0.67, P < .001); 60 to 69 years (HR: 0.70, P < .001); and ≥70 years (HR: 0.79, P < .001). Finally, in T1b patients, as well as in T2 patients, no other-cause mortality advantage was recorded for partial vs. radical nephrectomy: T1b (8 vs. 10%, Δ=2%); T2 (8 vs. 9%, Δ=1%).
    Conclusions: Relative to radical nephrectomy, partial nephrectomy is associated with lower other-cause mortality in stage T1a renal cell carcinoma patients across all age categories, including the oldest patients. Conversely, no clinically meaningful other-cause mortality benefit was associated with partial nephrectomy in stages T1b or T2, regardless of age, including youngest patients.
    MeSH term(s) Humans ; Middle Aged ; Carcinoma, Renal Cell/pathology ; Kidney Neoplasms/pathology ; Neoplasm Staging ; Nephrectomy/methods ; Incidence
    Language English
    Publishing date 2023-11-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2225121-2
    ISSN 1938-0682 ; 1558-7673
    ISSN (online) 1938-0682
    ISSN 1558-7673
    DOI 10.1016/j.clgc.2023.10.011
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  8. Article: Epidemiology of renal colic in a district general hospital.

    Trinchieri, Alberto / Cappoli, Stefano / Esposito, Nicola / Acquati, Pietro

    Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica

    2008  Volume 80, Issue 1, Page(s) 1–4

    Abstract: Background/aims: To assess the incidence of renal colic and the results of emergency management.: Methods: During a 12 month period data of patients with symptoms of renal colic were collected.: Results: A total of 495 visits were registered. The ... ...

    Abstract Background/aims: To assess the incidence of renal colic and the results of emergency management.
    Methods: During a 12 month period data of patients with symptoms of renal colic were collected.
    Results: A total of 495 visits were registered. The M/F was 2.19. Mean age was higher in males (45.5+/-13.0 vs 42.5+/-15.5 years, P=0.025). Three patients were hospitalised for immediate urinary diversion due to anuria or sepsis. Fifty-three patients recovered without performing any pharmacological treatment. Analgesic treatment (mainly NSAID) was offered to 439 patients. After a 6 hour period 36 patients were admitted to the hospital owing to persistent pain. Pain was reduced in 403 patients (91.8%) who were offered outpatient renal ultrasound within 48 hours. Twenty-five patients (6.2%) required deferred hospitalisation. Follow up with renal ultrasound was obtained in 213.
    Conclusion: Renal colics accounted for 0.9% of ambulatory care visits to our emergency departments with an annual rate of 0.158 visits per 100 in the general population. NSAIDs were efficacious in the management of colic. Diagnostic work up was able to demonstrate the presence of a stone in 56% of the subjects presenting with renal colic whereas alternative diagnoses were demonstrated in 12%.
    MeSH term(s) Adult ; Analgesics/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Colic/diagnostic imaging ; Colic/drug therapy ; Colic/epidemiology ; Colic/etiology ; Drug Therapy, Combination ; Emergency Service, Hospital/statistics & numerical data ; Female ; Follow-Up Studies ; Hospitals, District ; Hospitals, General/statistics & numerical data ; Humans ; Incidence ; Italy/epidemiology ; Kidney Calculi/complications ; Kidney Calculi/diagnostic imaging ; Kidney Calculi/drug therapy ; Kidney Calculi/epidemiology ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Ultrasonography
    Chemical Substances Analgesics ; Anti-Inflammatory Agents, Non-Steroidal
    Language English
    Publishing date 2008-03
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 1153526-x
    ISSN 2282-4197 ; 1124-3562 ; 1120-8538
    ISSN (online) 2282-4197
    ISSN 1124-3562 ; 1120-8538
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  9. Article ; Online: Nephroureterectomy with or without Bladder Cuff Excision for Localized Urothelial Carcinoma of the Renal Pelvis.

    Nazzani, Sebastiano / Preisser, Felix / Mazzone, Elio / Tian, Zhe / Mistretta, Francesco A / Soulières, Denis / Montanari, Emanuele / Acquati, Pietro / Briganti, Alberto / Shariat, Shahrokh F / Abdollah, Firas / Carmignani, Luca / Karakiewicz, Pierre I

    European urology focus

    2018  Volume 6, Issue 2, Page(s) 298–304

    Abstract: Background: Few studies examined the rates of guideline implementation and the survival effect of bladder cuff excision (BCE) at nephroureterectomy (NU).: Objective: To assess the rates of guideline implementation regarding NU with BCE relative to NU ...

    Abstract Background: Few studies examined the rates of guideline implementation and the survival effect of bladder cuff excision (BCE) at nephroureterectomy (NU).
    Objective: To assess the rates of guideline implementation regarding NU with BCE relative to NU without BCE in patients with upper tract urothelial carcinoma (UTUC) and to test the effect of BCE on cancer-specific (CSM) and other-cause mortality (OCM).
    Design, setting, and participants: We relied on Surveillance, Epidemiology, and End Results database (2004-2014) for UTUC of the renal pelvis patients (T1-T3, N0, M0) treated with NU with or without BCE.
    Outcome measurements and statistical analysis: Cumulative incidence plots relying on competing-risks methodology illustrated 5-yr CSM and OCM rates. Multivariable competing-risks regression (MCRR) models tested the effect of BCE versus no BCE at NU.
    Results and limitations: Of 4266 assessable patients, 2913 (68.3%) underwent NU with BCE. Between 2004 and 2014, rates of BCE at NU increased from 63.0% to 74.5% (European Association for Palliative Care: 2%; p<0.001). At 60 mo, CSM rates were 19.7% versus 23.5% (p=0.005) in NU with BCE versus NU without BCE patients, respectively. In MCRR models, no difference in CSM was recorded according to BCE at NU (hazard ratio [HR]: 0.88, confidence interval [CI]: 0.75-1.03, p=0.1). Finally, OCM was unaffected by BCE at NU (HR: 0.94, CI: 0.77-1.15, p=0.5). This study is retrospective.
    Conclusions: According to guideline recommendation, the rates of NU with BCE increased over time. However, BCE status does not appear to affect CSM or OCM. Thus, our study was unable to examine the rates of urothelial cancer recurrence or metastatic progression according to BCE status.
    Patient summary: Rates of bladder cuff excision (BCE) at nephroureterectomy (NU) are increasing. This observation confirms improved adherence to guidelines over time. However, BCE status does not appear to affect survival after NU for upper tract urothelial carcinoma.
    MeSH term(s) Adult ; Carcinoma, Transitional Cell/surgery ; Female ; Guideline Adherence/statistics & numerical data ; Humans ; Kidney Neoplasms/pathology ; Kidney Neoplasms/surgery ; Kidney Pelvis ; Male ; Middle Aged ; Nephroureterectomy/methods ; Nephroureterectomy/standards ; Retrospective Studies ; Urinary Bladder/pathology ; Urinary Bladder/surgery
    Language English
    Publishing date 2018-09-25
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2405-4569
    ISSN (online) 2405-4569
    DOI 10.1016/j.euf.2018.09.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Rates of lymph node invasion and their impact on cancer specific mortality in upper urinary tract urothelial carcinoma.

    Nazzani, Sebastiano / Mazzone, Elio / Preisser, Felix / Tian, Zhe / Mistretta, Francesco A / Shariat, Shahrokh F / Montanari, Emanuele / Acquati, Pietro / Briganti, Alberto / Saad, Fred / Carmignani, Luca / Karakiewicz, Pierre I

    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

    2018  Volume 45, Issue 7, Page(s) 1238–1245

    Abstract: Purpose: To analyze lymph node invasion (LNI) rates according to tumor characteristics and to test the impact of LNI and its extent on cancer specific mortality (CSM) in surgically-treated non metastatic urothelial upper urinary tract carcinoma (UTUC) ... ...

    Abstract Purpose: To analyze lymph node invasion (LNI) rates according to tumor characteristics and to test the impact of LNI and its extent on cancer specific mortality (CSM) in surgically-treated non metastatic urothelial upper urinary tract carcinoma (UTUC) patients.
    Materials and methods: Within the SEER database (2004-2014), we identified 2098 patients with histologically confirmed non-metastatic urothelial carcinoma of renal pelvis or ureter who underwent NU with LND. LNI rates stratified according to tumor location and stage were described. Kaplan-Meier plots illustrated CSM rates according to LNI and its extent. Multivariable Cox regression models (MCRMs) tested the effect of LNI and its extent on CSM.
    Results: Of 2098 UTUC patients, who underwent nephroureterectomy with lymph node dissection, 646 (33%) had LNI. The median number of removed lymph nodes was 3 [Interquartile range (IQR): 1-7]. The median number of positive lymph nodes in patients, who harbored LNI was 1 (IQR:1-3). LNI rates according to tumor location were, respectively, 23.6% for ureteral and 36.5% for renal pelvis tumors. LNI rates according to tumor stage were 9.6, 18.0, 38.7 and 63.9%, for respectively, T1, T2, T3 and T4 UTUC. In MCRMs, LNI achieved independent predictor status for higher CSM (HR 3.00; p < 0.001). Finally, in MCRMs, number of positive lymph nodes defined as the 75th percentile (n ≥ 3) achieved independent predictor status for higher CSM (HR 1.37; p = 0.04).
    Conclusions: LNI in non-metastatic UTUC patients is the most important determinant of CSM. Number of positive lymph node is independently associated with higher CSM. In consequence, lymph node dissection can provide extensive prognostic information.
    MeSH term(s) Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell/mortality ; Carcinoma, Transitional Cell/pathology ; Carcinoma, Transitional Cell/surgery ; Chemotherapy, Adjuvant ; Female ; Humans ; Kidney Neoplasms/mortality ; Kidney Neoplasms/pathology ; Kidney Neoplasms/surgery ; Kidney Pelvis/pathology ; Lymph Node Excision ; Lymph Nodes/pathology ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Nephroureterectomy ; Prognosis ; SEER Program ; Ureteral Neoplasms/mortality ; Ureteral Neoplasms/pathology ; Ureteral Neoplasms/surgery
    Language English
    Publishing date 2018-12-11
    Publishing country England
    Document type Journal Article
    ZDB-ID 632519-1
    ISSN 1532-2157 ; 0748-7983
    ISSN (online) 1532-2157
    ISSN 0748-7983
    DOI 10.1016/j.ejso.2018.12.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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