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Artikel ; Online: Medium-term follow up of active surveillance for early prostate cancer at a non-academic institution.

Leni, Riccardo / Roscigno, Marco / Barzaghi, Paolo / La Croce, Giovanni / Catellani, Michele / Saccà, Antonino / de Angelis, Mario / Montorsi, Francesco / Briganti, Alberto / Da Pozzo, Luigi Filippo

BJU international

2024 Band 133, Heft 5, Seite(n) 614–621

Abstract: Objectives: To report oncological outcomes of active surveillance (AS) at a single non-academic institution adopting the standardised Prostate Cancer Research International Active Surveillance (PRIAS) protocol.: Patients and methods: Competing risk ... ...

Abstract	Objectives: To report oncological outcomes of active surveillance (AS) at a single non-academic institution adopting the standardised Prostate Cancer Research International Active Surveillance (PRIAS) protocol. Patients and methods: Competing risk analyses estimated the incidence of overall mortality, metastases, conversion to treatment, and grade reclassification. The incidence of reclassification and adverse pathological findings at radical prostatectomy were compared between patients fulfilling all PRIAS inclusion criteria vs those not fulfilling at least one. Results: We analysed 341 men with Grade Group 1 prostate cancer (PCa) followed on AS between 2010 and 2022. There were no PCa deaths, two patients developed distant metastases and were alive at the end of the study period. The 10-year cumulative incidence of metastases was 1.9% (95% confidence interval [CI] 0.33-6.4%). A total of 111 men were reclassified, and 127 underwent definitive treatment. Men not fulfilling at least one PRIAS inclusion criteria (n = 43) had a higher incidence of reclassification (subdistribution hazards ratio 1.73, 95% CI 1.07-2.81; P = 0.03), but similar rates of adverse pathological findings at radical prostatectomy. Conclusion: Metastases in men on AS at a non-academic institution are as rare as those reported in established international cohorts. Men followed without stringent inclusion criteria should be counselled about the higher incidence of reclassification and reassured they can expect rates of adverse pathological findings comparable to those fulfilling all criteria. Therefore, AS should be proposed to all men with low-grade PCa regardless of whether they are followed at academic institutions or smaller community hospitals.
Mesh-Begriff(e)	Humans ; Male ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery ; Prostatic Neoplasms/therapy ; Prostatic Neoplasms/mortality ; Watchful Waiting ; Middle Aged ; Aged ; Follow-Up Studies ; Prostatectomy ; Neoplasm Grading ; Neoplasm Metastasis
Sprache	Englisch
Erscheinungsdatum	2024-01-22
Erscheinungsland	England
Dokumenttyp	Journal Article
ZDB-ID	1462191-5
ISSN	1464-410X ; 1464-4096 ; 1358-8672
ISSN (online)	1464-410X
ISSN	1464-4096 ; 1358-8672
DOI	10.1111/bju.16259
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: The Accuracy of Transurethral Bladder Resection in Detecting Bladder Cancer Histological Variants and Their Prognostic Value at Radical Cystectomy.

La Croce, Giovanni / Naspro, Richard / Finati, Marco / Pellucchi, Federico / Sodano, Mario / Manica, Michele / Catellani, Michele / Gianatti, Andrea / Roscigno, Marco / Da Pozzo, Luigi Filippo

Journal of clinical medicine

2022 Band 11, Heft 3

Abstract: Objectives: to investigate the accuracy of transurethral resection of bladder tumours (TURBT) in detecting histological variants (BHV) at radical cystectomy (RC) and to evaluate the impact of TURBT before cystectomy on oncological outcomes.: Methods: ...

Abstract	Objectives: to investigate the accuracy of transurethral resection of bladder tumours (TURBT) in detecting histological variants (BHV) at radical cystectomy (RC) and to evaluate the impact of TURBT before cystectomy on oncological outcomes. Methods: Data of 410 consecutive RCs were assessed. Positive and negative predictive values were used to assess the accuracy of TURBT in detecting BHV. Cohen's Kappa coefficient was used to calculate the agreement grade. Logistic regression analysis predicted features based on the presence of BHV at TURBT. Multivariable backward conditional Cox regression analysis was used to estimate oncological outcomes. Results: A total of 73 patients (17.8%) showed BHV at TURBT as compared to 108 (26.3%) at RC. A moderate agreement in histological diagnosis was found between TURBT and RC (0.58). However, sensitivity and specificity in detecting BHV were 56% and 96%, respectively. Furthermore, positive predictive value (PPV) was 84.7% and negative predictive value (NPV) was 84.6%. Presence of BHV at TURBT was an independent predictor for pathologic upstage, albeit not a predictor for positive nodes or positive surgical margins. However, at multivariable analysis adjusted for all confounders, presence of BHV at TURBT was an independent predictor for recurrence after RC, but not for survival. Conversely, the presence of BHV at RC was an independent predictor for both recurrence and survival. Conclusion: There was a moderate agreement between TURBT and RC histopathological findings. TURBT, alone, could not provide an accurate and definitive histological diagnosis. Detection of BHV in TURBT specimens is not an independent predictor of oncological outcomes; indeed, only pathological features at RC are associated with worse survival. However, BHV presence in cystectomy specimens resulted as an independent predictor of both cancer-specific and overall mortality.
Sprache	Englisch
Erscheinungsdatum	2022-01-22
Erscheinungsland	Switzerland
Dokumenttyp	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11030550
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Extended pelvic lymph node dissection during radical prostatectomy: comparison between initial robotic experience of a high-volume open surgeon and his contemporary open series.

Roscigno, Marco / La Croce, Giovanni / Naspro, Richard / Nicolai, Maria / Manica, Michele / Scarcello, Manuela / Chinaglia, Daniela / Da Pozzo, Luigi F

Minerva urologica e nefrologica = The Italian journal of urology and nephrology

2019 Band 71, Heft 6, Seite(n) 597–604

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 ... ...

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.
Mesh-Begriff(e)	Adult ; Aged ; Aged, 80 and over ; Humans ; Learning Curve ; Lymph Node Excision/methods ; Male ; Margins of Excision ; Middle Aged ; Neoplasm Grading ; Operative Time ; Pelvis ; Prospective Studies ; Prostatectomy/methods ; Prostatic Neoplasms/pathology ; Prostatic Neoplasms/surgery ; Robotic Surgical Procedures/methods ; Surgeons ; Treatment Outcome
Sprache	Englisch
Erscheinungsdatum	2019-05-28
Erscheinungsland	Italy
Dokumenttyp	Comparative Study ; Journal Article
ZDB-ID	632505-1
ISSN	1827-1758 ; 0393-2249 ; 0026-4989
ISSN (online)	1827-1758
ISSN	0393-2249 ; 0026-4989
DOI	10.23736/S0393-2249.19.03404-0
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Oncological outcomes of concomitant carcinoma in situ at radical cystectomy in pure urothelial bladder cancer and in histological variants.

Naspro, Richard / La Croce, Giovanni / Finati, Marco / Roscigno, Marco / Pellucchi, Federico / Sodano, Mario / Manica, Michele / Gianatti, Andrea / Da Pozzo, Luigi F

Urologic oncology

2021 Band 40, Heft 2, Seite(n) 61.e9–61.e19

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 ... ...

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.
Mesh-Begriff(e)	Aged ; Cystectomy/methods ; Female ; Humans ; Male ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/surgery
Sprache	Englisch
Erscheinungsdatum	2021-07-29
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	1336505-8
ISSN	1873-2496 ; 1078-1439
ISSN (online)	1873-2496
ISSN	1078-1439
DOI	10.1016/j.urolonc.2021.07.009
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: The impact of histological variants on outcomes after open radical cystectomy for muscle-invasive urothelial bladder cancer: results from a single tertiary referral centre.

Naspro, Richard / Finati, Marco / Roscigno, Marco / Pellucchi, Federico / La Croce, Giovanni / Sodano, Mario / Manica, Michele / Chinaglia, Daniela / Da Pozzo, Luigi F

World journal of urology

2020 Band 39, Heft 6, Seite(n) 1917–1926

Abstract: Objectives: To evaluate the impact of histological variants on oncological outcomes of patients with muscle-invasive bladder cancer treated with open radical cystectomy and furthermore to determine any association between survival and each histotype of ... ...

Abstract	Objectives: To evaluate the impact of histological variants on oncological outcomes of patients with muscle-invasive bladder cancer treated with open radical cystectomy and furthermore to determine any association between survival and each histotype of bladder cancer. Materials and methods: Data from 525 consecutive patients with muscle-invasive bladder cancer treated with radical cystectomy between January 2008 and May 2019 were collected retrospectively. The Kaplan-Meier curves and multivariable analysis addressed the role of histological variants in recurrence, cancer-specific and overall mortality between all subgroups. Results: Of 525 patients, 131 (25.0%) showed a histological variant at radical cystectomy. With a median follow-up of 31 months, 209 (39.8%) recurrences, 184 (35.0%) cancer-related deaths and 260 (49.5%) overall deaths were reported. The presence of histological variant was associated with advanced tumour stage, the presence of concomitant carcinoma in situ, lymph node metastasis, lymphovascular invasion and positive surgical margins compared to pure urothelial bladder cancer (all p values < .008) and resulted as an independent risk factor for cancer-specific mortality (p = 0.001). Patients with a histological variant were at significantly higher risk for recurrence, cancer-specific mortality and overall mortality (all p values ≤ .001). Micropapillary, sarcomatoid or small cell differentiation was associated with reduced survival. Conclusion: The presence of histological variants at radical cystectomy seems to be weakly associated with reduced survival compared to pure urothelial bladder cancer paired for pathologic stage. The association of histological variants with advanced and biologically aggressive tumours suggests the need for attention on the overall management of these patients, in particular for micropapillary, sarcomatoid and small cell differentiation.
Mesh-Begriff(e)	Aged ; Carcinoma, Transitional Cell/mortality ; Carcinoma, Transitional Cell/pathology ; Carcinoma, Transitional Cell/surgery ; Cystectomy/methods ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Retrospective Studies ; Survival Rate ; Tertiary Care Centers ; Treatment Outcome ; Urinary Bladder Neoplasms/mortality ; Urinary Bladder Neoplasms/pathology ; Urinary Bladder Neoplasms/surgery
Sprache	Englisch
Erscheinungsdatum	2020-07-21
Erscheinungsland	Germany
Dokumenttyp	Journal Article
ZDB-ID	380333-8
ISSN	1433-8726 ; 0724-4983
ISSN (online)	1433-8726
ISSN	0724-4983
DOI	10.1007/s00345-020-03364-z
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Which patient may benefit the most from penile prosthesis implantation?

Andrology

2022 Band 10, Heft 8, Seite(n) 1567–1574

Abstract: Background: Penile prosthesis implantation has been associated with overall good functional outcomes. Of relevance, some patients reported higher level of satisfaction and quality of life.: Aim: We investigated the profile of the patients who may ... ...

Abstract	Background: Penile prosthesis implantation has been associated with overall good functional outcomes. Of relevance, some patients reported higher level of satisfaction and quality of life. Aim: We investigated the profile of the patients who may benefit the most from penile prosthesis implantation. Materials and methods: Data from a national multi-institutional registry of penile prostheses including patients treated from 2014 to 2017 in Italy (Italian Nationwide Systematic Inventarization of Surgical Treatment for Erectile Dysfunction) were analyzed. All data have been prospectively recorded by 45 surgeons on a dedicated website (www.registro.andrologiaitaliana.it) and revised by a single data manager. Patients' baseline characteristics were recorded. In order to simultaneously evaluate perceived penile prosthesis function and quality of life, all patients were re-assessed at 1-year follow-up using the validated questionnaire Quality of Life and Sexuality with Penile Prosthesis. High quality of life after surgery was defined as a score higher than the 75th percentile in each of the subdomains of the Quality of Life and Sexuality with Penile Prosthesis questionnaire. Logistic regression analysis tested the association between clinical characteristics and high quality of life after penile prosthesis implantation. Results: Follow-up data were available for 285 patients (median age 60 years; interquartile range: 56-67) who underwent penile prosthesis implantation. Erectile dysfunction etiology was organic in 40% (114), pelvic surgery/radiotherapy in 39% (111), and Peyronie's disease in 21% (60) of the cases. Patients showed good overall Quality of Life and Sexuality with Penile Prosthesis scores at 1-year follow-up for functional (22/25), personal (13/15), relational (17/20), and social (13/15) domains. Overall, 27.0% (77) of patients achieved scores consistent with the high quality of life definition. These patients did not differ in terms of median age (60 vs. 62), type of prosthesis (inflatable penile prostheses: 95% in both of the cases), and post-operative complications (10% vs. 14%) than those with lower quality of life score (all p > 0.1). At logistic regression analysis, erectile dysfunction etiology was the only factor independently associated with high quality of life at 1 year after surgery (p = 0.02). Patients treated for Peyronie's disease (odds ratio: 2.62; p = 0.01; 95% confidence interval: 1.20-5.74) were more likely to report better outcomes after accounting for age, post-operative complications, and surgical volume. Conclusion: Penile prosthesis implantation is associated with an overall good quality of life. The subset of patients affected by erectile dysfunction secondary to Peyronie's disease seemed to benefit the most from penile prosthesis implantation in terms of functional outcomes, relationship with their partners and the outside world, and perceived self-image. The systematic use of validated questionnaires specifically addressed at evaluating quality of life and satisfaction after penile prosthesis implantation should be further implemented in future studies to better define the predictors of optimal satisfaction after penile prosthesis implantation.
Mesh-Begriff(e)	Erectile Dysfunction/complications ; Erectile Dysfunction/surgery ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Penile Implantation/adverse effects ; Penile Implantation/methods ; Penile Induration/surgery ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Quality of Life
Sprache	Englisch
Erscheinungsdatum	2022-09-26
Erscheinungsland	England
Dokumenttyp	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2696108-8
ISSN	2047-2927 ; 2047-2919
ISSN (online)	2047-2927
ISSN	2047-2919
DOI	10.1111/andr.13294
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Repeated biopsy in the detection of prostate cancer: when and how many cores.

Scattoni, Vincenzo / Russo, Andrea / Di Trapani, Ettore / Capitanio, Umberto / La Croce, Giovanni / Montorsi, Francesco

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

2014 Band 86, Heft 4, Seite(n) 311–313

Abstract: Purpose: We performed an analysis of the literature about the optimal prostate biopsy (PBX) scheme in the repeated setting: Methods: We performed a clinical and critical literature review by searching Medline Database from January 2005 up to January ... ...

Abstract	Purpose: We performed an analysis of the literature about the optimal prostate biopsy (PBX) scheme in the repeated setting Methods: We performed a clinical and critical literature review by searching Medline Database from January 2005 up to January 2014. Electronic searches were limited to the English language. The keywords were: prostate cancer, prostate biopsy, transrectal ultrasound, transperineal prostate biopsy. Results: The recommended approach in repeated setting is still the extended scheme (EPBx) (12 cores). An approach with more than 12 cores according to the clinical characteristics of the patients may optimize cancer detection. Saturation PBx (> 20 cores) clearly improves cancer detection if clinical suspicion persists after previous negative biopsy. Nevertheless international guidelines do not strongly recommended SPBx in all situations of repeated setting. EPBx or SPBX may be, in the future, substituted by multiparametric MRI-targeted biopsies. Conclusions: Since the scenario in which a PBx is changing, the issue about the number and location of the cores in PBx is still a matter of debate in repeated setting. At present, EPBx are still the gold standard even if SPBx seems to be necessary in many cases. However, random PBx does not represent the approach of the future, but rather imaging targeted biopsy.
Mesh-Begriff(e)	Biopsy/methods ; Biopsy/statistics & numerical data ; Humans ; Male ; Prostate/pathology ; Prostatic Neoplasms/pathology
Sprache	Englisch
Erscheinungsdatum	2014-12-30
Erscheinungsland	Italy
Dokumenttyp	Journal Article ; Review
ZDB-ID	1153526-x
ISSN	2282-4197 ; 1124-3562 ; 1120-8538
ISSN (online)	2282-4197
ISSN	1124-3562 ; 1120-8538
DOI	10.4081/aiua.2014.4.311
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel: Multiparametric magnetic resonance imaging and clinical variables: Which is the best combination to predict reclassification in active surveillance patients?

Roscigno, Marco / Stabile, Armando / Lughezzani, Giovanni / Pepe, Pietro / Dell'Atti, Lucio / Naselli, Angelo / Naspro, Richard / Nicolai, Maria / La Croce, Giovanni / Muhannad, Aljoulani / Perugini, Giovanna / Guazzoni, Giorgio / Montorsi, Francesco / Balzarini, Luca / Sironi, Sandro / Da Pozzo, Luigi F

Prostate international

2020 Band 8, Heft 4, Seite(n) 167–172

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 ... ...

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 ( 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.
Sprache	Englisch
Erscheinungsdatum	2020-05-28
Erscheinungsland	Korea (South)
Dokumenttyp	Journal Article
ZDB-ID	2711928-2
ISSN	2287-903X ; 2287-8882
ISSN (online)	2287-903X
ISSN	2287-8882
DOI	10.1016/j.prnil.2020.05.003
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: The Use of Multiparametric Magnetic Resonance Imaging for Follow-up of Patients Included in Active Surveillance Protocol. Can PSA Density Discriminate Patients at Different Risk of Reclassification?

Roscigno, Marco / Stabile, Armando / Lughezzani, Giovanni / Pepe, Pietro / Galosi, Andrea Benedetto / Naselli, Angelo / Naspro, Richard / Nicolai, Maria / La Croce, Giovanni / Aljoulani, Muhannad / Perugini, Giovanna / Guazzoni, Giorgio / Montorsi, Francesco / Balzarini, Luca / Sironi, Sandro / Da Pozzo, Luigi Filippo

Clinical genitourinary cancer

2020 Band 18, Heft 6, Seite(n) e698–e704

Abstract: Introduction: The objective of this study was to test Prostate Imaging Reporting and Data System (PI-RADS) classification on multiparametric magnetic resonance imaging (mpMRI) and MRI-derived prostate-specific antigen density (PSAD) in predicting the ... ...

Abstract	Introduction: The objective of this study was to test Prostate Imaging Reporting and Data System (PI-RADS) classification on multiparametric magnetic resonance imaging (mpMRI) and MRI-derived prostate-specific antigen density (PSAD) in predicting the risk of reclassification in men in active surveillance (AS), who underwent confirmatory or per-protocol follow-up biopsy. Materials and methods: Three hundred eighty-nine patients in AS underwent mpMRI before confirmatory or follow-up biopsy. Patients with negative (-) mpMRI underwent systematic random biopsy. Patients with positive (+) mpMRI underwent targeted fusion prostate biopsies + systematic random biopsies. Different PSAD cutoff values were tested (< 0.10, 0.10-0.20, ≥ 0.20). Multivariable analyses assessed the risk of reclassification, defined as clinically significant prostate cancer of grade group 2 or more, during follow-up according to PSAD, after adjusting for covariates. Results: One hundred twenty-seven (32.6%) patients had mpMRI(-); 72 (18.5%) had PI-RADS 3, 150 (38.6%) PI-RADS 4, and 40 (10.3%) PI-RADS 5 lesions. The rate of reclassification to grade group 2 PCa was 16%, 22%, 31%, and 39% for mpMRI(-) and PI-RADS 3, 4, and 5, respectively, in case of PSAD < 0.10 ng/mL Conclusion: PSAD ≥ 0.20 ng/mL
Mesh-Begriff(e)	Follow-Up Studies ; Humans ; Image-Guided Biopsy ; Magnetic Resonance Imaging ; Male ; Multiparametric Magnetic Resonance Imaging ; Prostate-Specific Antigen ; Prostatic Neoplasms/diagnostic imaging ; Retrospective Studies ; Watchful Waiting
Chemische Substanzen	Prostate-Specific Antigen (EC 3.4.21.77)
Sprache	Englisch
Erscheinungsdatum	2020-05-04
Erscheinungsland	United States
Dokumenttyp	Journal Article
ZDB-ID	2225121-2
ISSN	1938-0682 ; 1558-7673
ISSN (online)	1938-0682
ISSN	1558-7673
DOI	10.1016/j.clgc.2020.04.006
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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Artikel ; Online: Avanafil - a further step to tailoring patient needs and expectations.

Boeri, Luca / Capogrosso, Paolo / Ventimiglia, Eugenio / Serino, Alessandro / La Croce, Giovanni / Russo, Andrea / Damiano, Rocco / Montorsi, Francesco / Salonia, Andrea

Expert review of clinical pharmacology

2016 Band 9, Heft 9, Seite(n) 1171–1181

Abstract: Introduction: Phosphodiesterase type 5 inhibitors (PDE5Is) represent the first-line treatment for erectile dysfunction (ED). Almost one in two patients, however, show some level of treatment dissatisfaction and up to 30% fail to respond to any of the ... ...

Abstract	Introduction: Phosphodiesterase type 5 inhibitors (PDE5Is) represent the first-line treatment for erectile dysfunction (ED). Almost one in two patients, however, show some level of treatment dissatisfaction and up to 30% fail to respond to any of the currently available PDE5Is. Recently, the second-generation PDE5I avanafil was launched for the treatment of ED. Areas covered: Pivotal studies of clinical development along with placebo-controlled randomized clinical trials (RCTs) of avanafil in patients with ED were reviewed. Studies concerning the pharmacokinetics and pharmacodynamic of the drug were also analysed. A systematic literature search for English-language studies published up to May 2016 using the Medline database was performed. The search included the terms avanafil and ED. Expert commentary: Avanafil is a potent, highly selective PDE5I whose efficacy is comparable to that of currently available PDE5Is in both naïve and previous PDE5I users. Avanafil is effective within approximately 15 minutes of dosing, thus representing the only PDE5I approved for as-needed use, 15 to 30 minutes before sexual activity. Avanafil has high selectivity for the PDE5 isoenzyme, thus resulting in a lower incidence of drug-related side effects compared to other PDE5Is.
Mesh-Begriff(e)	Erectile Dysfunction/drug therapy ; Erectile Dysfunction/physiopathology ; Humans ; Male ; Patient Satisfaction ; Phosphodiesterase 5 Inhibitors/adverse effects ; Phosphodiesterase 5 Inhibitors/pharmacology ; Phosphodiesterase 5 Inhibitors/therapeutic use ; Pyrimidines/adverse effects ; Pyrimidines/pharmacology ; Pyrimidines/therapeutic use ; Randomized Controlled Trials as Topic ; Time Factors ; Treatment Outcome
Chemische Substanzen	Phosphodiesterase 5 Inhibitors ; Pyrimidines ; avanafil (DR5S136IVO)
Sprache	Englisch
Erscheinungsdatum	2016-09
Erscheinungsland	England
Dokumenttyp	Comparative Study ; Journal Article ; Review
ISSN	1751-2441
ISSN (online)	1751-2441
DOI	10.1080/17512433.2016.1195261
Datenquelle	MEDical Literature Analysis and Retrieval System OnLINE

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