CORSO Carcinoma vescicale non muscolo invasivo : qualità del trattamento endoscopico

Sebbene la resezione endoscopica per via transuretrale (TURBT) rappresenti lo standard per la diagnosi, la stadiazione e il primo trattamento delle neoplasie vescicali, la sua efficacia rimane ad oggi limitata a causa di numerose limitazioni intrinseche alla stessa procedura. I principali limiti oncologici della TURBT sono rappresentati da – violazione della asportazione en bloc della neoplasia, -inefficacia nei confronti delle lesioni piatte o non riconoscibile endoscopicamente, -incompletezza della resezione. Anche la qualità della esecuzione tecnica della resezione, in mancanza di adeguati standard e programmi di insegnamento è ridotta in moltissimi contesti clinici. Di conseguenza, la T…

Compliance to therapy with Dapoxetine in comparison to a conventional selective serotonin reuptake inhibitor (Citalopram) in 118 patients with premature ejaculation.

Premature Ejaculation (PE) is a sexual dysfunction that concern 20-30% of the male population. Dapoxetine is a new serotonine re-uptake inhibitor (SSRI)specific for PE treatment.Aim of the study is to assess compliance and effectiveness of the treatment with dapoxetine compared to the treatment with citalopram (a classic SSRI used to treat PE).

Ipertermia e chemioterapia nel tumore vescicale superficiale a medio rischio di recidiva:esperienza preliminare

S9-Fibronectin, EGF-R, HB-EGF:biomarkers of urothelial damage during intravesical adjuvant therapy?

Intravesical chemotherapy and immunotherapy with BCG represent the standard therapy to prevent recurrence after transurethral resection (TUR) of non-muscle invasive bladder cancer (NMI-BC). Maintenance for at least one year is considered the best regimen. Noteworthy, a relevant number of patients do not complete the planned treatment due to local toxicity of the drug given intravesically1, 2. A major challenge for the urologists is to identify an early urothelial damage biomarker to prevent severe local toxicity requiring treatment interruption and to improve patient's compliance. The preliminary purpose of our research was to verify the possible correlation between urothelial damage induce…

38: Drinking Water Source and Cigarette Smoking in Transitional Cell Carcinoma of the Bladder

Management of bicalutamide induced gynaecomastia. A randomized study comparing therapy versus prophylaxis with tamoxifen.

Introduction and Objective: Gynaecomastia is a potentially treatment limiting adverse event of antiandrogen monotherapy for prostate cancer. Tamoxifen has shown to be effective in therapy and prophylaxis of gynecomastia and breast pain. However, tamoxifene dosage and treatment duration are not established and debate still exists if prophylaxis is more effective than therapy at the early onset. This randomized study compared the prophylactic activity of tamoxifene at the dose of 10 mg with its therapeutic activity when given at the dose of 20 mg at the early appearance of gynecomastia in patients receiving bicalutamide 150 mg/d for prostate cancer. Methods: Between June 2005 and June 2007, 1…

Cabazitaxel in Metastatic Castration-Resistant Prostate Cancer Patients Progressing after Docetaxel: A Prospective Single-Center Study

<b><i>Purpose:</i></b> The present study aims to evaluate the efficacy of cabazitaxel in combination with prednisone treatment in Italian patients affected by hormone-refractory metastatic castration-resistant prostate cancer (mCRPC) previously treated with docetaxel plus prednisone. <b><i>Methods:</i></b> Thirty patients with mCRPC were enrolled between June 2013 and January 2016 (the last follow-up was in January 2016). Cabazitaxel was used according to the summary of product characteristics and administered at a dose of 25 mg/m<sup>2</sup> every 3 weeks plus oral prednisone at a dose of 5-mg tablets twice a day continuously. The…

Fibronectin urothelial gene expression as a new reliable biomarker for early detection of local toxicity secondary to adjuvant intravesical therapy for non-muscle invasive bladder cancer.

Background: A marker of urothelial damage could be helpful for early detection and monitoring of local toxicity due to intravesical therapy for non-muscle invasive bladder cancer (NMIBC). The aim of the study was to investigate the correlation between fibronectin (FN) gene expression in bladder washings and local toxicity secondary to adjuvant intravesical therapy. Materials and methods: Patients undergoing adjuvant intravesical therapy for NMIBC and age-matched healthy patients were enrolled. Real time polymerase chain reaction was performed to analyze FN expression in bladder washings. Local toxicity was classified as: 0–1 mild (no medical therapy), 2 moderate (medical therapy and/or inst…

Preoperative favourable characteristics in bladder cancer patients cannot substitute the necessity of extended lymphadenectomy during radical cystectomy: A sensitivity curve and a survival analysis

Modificazioni del PSA dopo terapia antibiotica in pazienti candidati alla biopsia prostatica.

Hypofractionated postoperative helical tomotherapy in prostate cancer: a mono-institutional report of toxicity and clinical outcomes

Francesco Cuccia,1,2 Gianluca Mortellaro,2 Vincenzo Serretta,3 Vito Valenti,1,2 Antonella Tripoli,1,2 Marina Gueci,1,2 Nicoletta Luca,1,2 Antonio Lo Casto,4 Giuseppe Ferrera2 1Radiation Oncology School, University of Palermo, Palermo, Italy; 2Radiation Oncology, ARNAS-Civico Hospital, Palermo, Italy; 3Section of Urology, Department of Surgical Oncological and Oral Science, University of Palermo, Palermo, Italy; 4Radiation Oncology School, Section of Radiological Sciences, DIBIMED, Università degli Studi di Palermo, Palermo, Italy Purpose: This is a mono-institutional study of acute and late toxicities and early biochemical control of a retrospective series of 75 prostate…

Leptin plasma levels in patients undergoing prostate biopsy. a preliminary study in 50 patients

Introduction/Aim: To reduce the number of negative prostate biopsies and to detect clinical significant prostate tumors in patients with elevated serum PSA represent major challenges in urological oncology. Prostate tumors diagnosed in patients with elevated Body Mass Index (BMI) show higher Gleason score and more aggressive biological behavior than those diagnosed in normal population (1). Elevated plasma levels of leptin and other adipose tissue derived factors (adipokines), are evident in obese men (2). Many studies have investigated the role of leptin as a putative molecular mediator between obesity and prostate cancer with contradictory results. Also in normal or overweight (BMI <30) m…

Epidemiology of Disease Conditions in Italy. Has Anything Changed? Environment, Professional Exposure, and Lifestyle. Is Time for Screening?

Risk factors analysis in bladder cancer should consider not only the clinical and pathological features of the tumor but also environmental and lifestyle factors. They may play, in fact, a relevant role not only in the pathogenesis but also in the biological behavior of the tumor. The association between cigarette smoking and bladder cancer has been consistently confirmed in several case-control and cohort studies. The risk of bladder cancer seems to increase with duration and intensity of smoking. Another environmental risk factor, although not definitively proved, is water supply. Chlorination or water pollution by pesticides and other chemical factors is considered a relevant risk facto…

Editorial Comment to Infectious aortic aneurysms occurring 1 year after bacillus Calmette–Guérin bladder instillation therapy

Editorial Comment

Water Chlorination and other environmental factors in bladder cancer. Result of a multicentre study.

Intravesical gemcitabine in superficial bladder tumours preliminary results of a phase I-II study

INTRODUCTION & OBJECTIVES: Gemcttabme is a pro-drug requmng intracellular phosphorylation by deoxycytidine kinase to be activated. Preliminary experiences. suggesting the activtty and the good tolerability of the drug on superficial transitional cell carcinoma of the bladder (TCCB) when administered by intravesical route, have been recently published. The mm of the present study was to evaluate the ablative efftcacy of weekly intravesical instillations of gemcitabine against paptllary marker lesions left after TUR of superficial TCCB. The scientific background and the ethical acceptability of thts approach have been balidated by the European Organization for Research and Treatment ot Cancer…

Il carcinoma prostatico in Sicilia e Calabria. età, stadiazione e PSA alla diagnosi

Does Exist A Correlation Between BMI and Gleason Patterns 4 and 5 At Prostate Biopsy?

Background: Obesity has been related with higher Gleason grade and worse prognosis. Increasing proportion of Gleason pattern 4 or 5 is a critical factor for biochemical recurrence, progression and mortality. The endocrine activity of visceral fat could be responsible of the differentation of the prostatic malignant cell towards a more aggressive fenotype. The aim of our study was to correlate Body Mass Index with the presence of Gleason pattern 4 or higher at biopsy. Materials and Methods: Consecutive patients with positive prostate biopsy were included. A transrectal prostate biopsy procedure with 12 cores, was performed. All tissue samples were reviewed. Results: Out of 135 patients diagn…

Carcinoma of the prostate. Guidelines for treatment: the role of antiandrogens.

Our preliminary experience shows that flutamide is effective in patients with stage C or D prostate cancer. Local and distant response rates are comparable to those obtained with "classic" hormone therapy. Libido and sexual potency generally are unaffected. Palliation of symptoms, which is frequent, is usually accompanied by improved performance status and quality of life. Side effects are slight or moderate, but elevated transaminase levels in patients with borderline liver insufficiency are possible.

Postoperative nomogram for invasive bladder cancer: does it really work? A multicenter cohort study.

Objectives: Nomograms are statistical models designed to maximize predictive accuracy. We have tested the statistical correlation between the predictions of International Bladder Cancer Nomogram Consortium and the clinical outcomes in a multicenter Italian cohort of patients treated with radical cystectomy (RC) and pelvic lymph-nodes dissection. Methods and materials: Two hundred four patients who underwent RC were selected for multiple variable and then enrolled in the study. Patients were tested by the "online tool" based on the nomogram, then stratified and risk grouped for 5-year predicted disease-free survival (pDFS): low risk (67%-100%), intermediate risk (34%-66%), and high risk grou…

Chemioterapia adiuvante nei tumori vescicali non muscolo invasivi a rischio intermedio. Risultati preliminari di uno studio retrospettivo multicentrico del Gruppo SIU per i tumori vescicali.

Introduzione e obiettivi Malgrado la chemioprofilassi endovescicale precoce dopo TUR sia indicata dalle linee guida in tutti i pazienti affetti da tumore vescicale non muscolo invasivo (NMI-BC), ancora dubbio rimane il miglior regime di terapia endovescicale adiuvante nei pazienti affetti da NMI-BC a rischio intermedio. Recenti studi sostengono l’adozione ab inizio del BCG. Vengono presentati i risultati preliminari di uno studio retrospettico multicentrico teso ad analizzare l’efficacia della chemioprofilassi endovescicale in questa categoria di pazienti e i diversi fattori che possono interferire sulla sua azione. Materiali e metodi Sono stati inseriti nello studio solo pazienti gia selez…

The clinical value of PSA increase during intravesical adjuvant therapy for nonmuscle-invasive bladder cancer.

Introduction Prostatic Specific Antigen (PSA), Bacillus Calmette-Guerin (BCG) increase after intravesical BCG has been reported. The need of prostate biopsy in these patients is object of debate. The aim of our study was to evaluate the effect of intravesical therapy on PSA after transurethral resection (TUR) of nonmuscle-invasive bladder cancer (NMIBC). Materials and methods Patients undergoing intravesical chemotherapy or immunotherapy for NMIBC were entered. PSA was measured before TUR, before the first and after the sixth instillation, 30 and 90 days after the last instillation. Patients with PSA ≥4 ng/ml or palpable prostate nodule were excluded. Results Out of 130 patients, 105 were e…

Analisi preliminare dei fattori demografici ed eziopatogenetici in pazienti affetti da carcinoma vescicale a medio rischio di recidiva

Prognostic factors and risk groups in T1G3 patients initially treated with BCG: Results of a multicenter retrospective series in 1743 patients

Introduction and Objectives: The impact of prognostic factors in T1G3 patients (pts) is critical for proper treatment decision making, however most available data are from small series of pts. The aim of the current study is to assess prognostic factors in a large group of pts who received BCG as initial treatment of T1G3 tumours and identify a subgroup of high risk pts who should be considered for early cystectomy. Patients and Methods: Individual pt data were collected for 1743 ptsfrom 20 centers who received induction or maintenance BCG between 1990 and 2008. Using Cox regression analysis, the prognostic importance of the following variables were assessed for time to recurrence, progress…

FOLLOW UP A LUNGO TERMINE DI PAZIENTI CON POSITIVITA’ DELLA NMP22 E NEGATIVITA’ CISTOSCOPICA E CITOLOGICA

22. Shariat SF, Perrotte P, Friedrich MG, Zippe CD, Boman H, Ludecke G, Sanchez-Carbayo M, Casella R, Mian C, Sawczuk IS, Sanaa E, Akaza H, Serretta V, Hedelin H, Rupesh R, Miyanaga N, Sagalowsky AI, Wians Institution variability in predictive accuracy of urinary cytology fro prediction of transitional cell carcinoma recurrence.

PROSPECTIVE, RANDOMIZED, CROSSOVER COMPARISON OF SUBLINGUAL APOMORPHINE (3 mg) WITH ORAL SILDENAFIL (50 mg) FOR MALE ERECTILE DYSFUNCTION

Abstract: Purpose: We established the efficacy and safety of sublingual apomorphine compared with oral sildenafil. in comparable groups of patients with erectile dysfunction (ED). Materials and Methods: This prospective, randomized, crossover study included 77 heterosexual men with ED of various etiologies and severities. A total of 62 men were randomized but only 34 were evaluable for efficacy and tolerability. The study started with a run-in period of 2 to 4 weeks. The first 4 weeks of treatment were followed by a washout period of 4 weeks, after which patients changed to the alternate treatment for an additional 4-week period. The sequence of the 2 treatments was established by a randomi…

Multiplicity and history have a detrimental effect on survival in patients with T1G3 bladder tumors selected for conservative treatment.

Purpose: In the absence of Tis tumor we assessed whether history and multiplicity have a detrimental effect on conservative treatment in carefully selected patients with T1G3 bladder carcinoma. Materials and Methods: Between January 1976 and December 1999, 165 select patients with T1G3 bladder tumors were conservatively treated with transurethral resection plus adjuvant intravesical therapy. Patients with concomitant or previous Tis, previous T1G3, tumor size greater than 3 cm and more than 3 lesions were excluded from analysis. Repeat transurethral resection was not routinely performed. However, cytology had to be negative for atypia before the start of adjuvant intravesical therapy. Resul…

Stereotactic Radiotherapy for the Treatment of Patients With Oligo-progressive Metastatic Renal Cell Carcinoma Receiving Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor: Data From the Real World

Aim This retrospective observational study evaluated the role of hypo-fractionated stereotactic radiotherapy (SRT) in patients with oligo-progressive metastatic renal cell carcinoma (mRCC) treated with first-line oral tyrosine kinase inhibitors (TKI). Data on local control, delay of further progression, and safety are reported. Patients and methods Between January 2010 and December 2016, 28 patients with mRCC who showed oligo-progressive disease while receiving first-line pazopanib were treated with hypofractionated SRT to progressive metastatic sites to delay the change of systemic therapy. First and second progression-free survival (PFS-1 and PFS-2) were recorded, as well as objective res…

The clinical use of statistical permutation test methodology: a tool for identifying predictive variables of outcome.

&lt;b&gt;&lt;i&gt;Objectives:&lt;/i&gt;&lt;/b&gt; To identify the predictive variables affecting the outcome after radical surgery for bladder cancer by a newer statistical methodology, i.e. nonparametric combination (NPC). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; A multicenter study enrolled 1,312 patients who had undergone radical cystectomy for bladder cancer in 11 Italian oncological centers from January 1982 to December 2002. A statistical analysis&lt;b&gt; &lt;/b&gt;of their medical history and diagnostic, pathological and postoperative variables was performed using a NPC test. The&lt;b&gt; &lt;/b&gt;patients were included in a comprehensive database with medical history and cli…

Plasma levels of angiogenetic markers in men candidate to prostate biopsy

MULTI-ISTITUTIONAL CONTROLLED STUDIES DO NO REFLECT THE PATIENT’S COMPLIANCE TO BCG ENCOUNTERED IN CLINICAL PRACTICE. RESULTS ON 411 PATIENTS

PATIENT’S COMPLIANCE TO BCG. DO WE ADEQUATELY CONSIDER IT?

Introduction: Several studies and meta-analysis demonstrated that BCG is the best treatment for conservative management of high-risk NMI-BC with a net benefit in terms of both recurrence-free and progression-free survival (1, 2). Maintenance lasting minimum one year is recommended. In spite of the effectiveness, the amount of patients who complete the manteinance schedule does not exceed 50% (3). The reasons of BCG maintenance interruption remain still unclear. The aim of our study was to investigate the causes of low adherence to 1-year full dose maintenance BCG in a large series. Patients and Methods: The clinical files of consecutive patients affected by T1 HG NMI-BC and undergoing adjuv…

Time to safely omit bladder cuff removal for low-risk upper tract urothelial carcinoma

Tumori del testicolo

THE IMPACT OF RE-TUR ON CLINICAL OUTCOMES IN A LARGE COHORT OF T1G3 PATIENTS TREATED WITH BCG.

Long-term outcome of antiandrogen monotherapy in advanced prostate carcinoma: 12-year results of a phase II study

OBJECTIVE To present the long-term outcome of patients with locally advanced or metastatic prostate carcinoma treated by first-line antiandrogen monotherapy. PATIENTS AND METHODS From 1983 to 1990, 41 patients with advanced prostate carcinoma were treated with flutamide monotherapy until progression or the appearance of toxicity. Twenty-five patients (61%) had T3-T4N0M0 and 16 (39%) T2–4N0–3M1 prostate carcinoma. Consensus criteria were adopted to evaluate the response. Plasma testosterone and sexual function were recorded for the first 3 years. RESULTS Flutamide was administered for up to 147 months; seven patients (17%) interrupted the treatment because of toxicity. There was an objective…

TERAPIA DI II LINEA NEL CARCINOMA PROSTATICO ORMONOREFRATTARIO (HRPC) CON ESTRAMUSTINA FOSFATO ED ETOPOSIDE. STUDIO DI FASE II DEL GSTU

A phase I-II study on intravesical Gemcitabine in superficial bladder papillary tumors

INTRODUCTION AND OBJECTIVE: The possible role of gemcitabine inintravesical therapy of superficial transitional cell carcinoma of the bladder (TCCB) has been suggested. The European Organization for Research and Treatment of Cancer Urological Group validated the use of papillary marker lesion left in the bladder after TUR as the best tool to measure the efficacy of a drug by intravesical route against TCCB. The rsults on 27 patients are herein presented. METHODS: Twenty-seven patients, with recurrent superficial TCCB (Ta-T1, G1-G2), were treated with intravesical gemcitabine for 1 to 3 papillary marker lesions (5-15 mm) left unreseacted after TUR. Twenty-one patients (78%) had recurrent tum…

uso degli alfa-bloccanti nell'ipertrofia prostatica benigna: il problema della "floppy iris syndrome". Risultati di uno studio caso-controllo per la valutazione del rischio pre-operatorio con la misura del diametro pupillare.

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Eziopatogenesi, diagnosi e fattori prognostici. Corso sulle neoplasie delle vie escretrici superiori.

Nomograms including nuclear matrix protein 22 for prediction of disease recurrence and progression in patients with Ta, T1 or CIS transitional cell carcinoma of the bladder

ABSTRACT Purpose: We developed and validated nomograms that accurately predict disease recurrence and progression in patients with Ta, T1, or CIS transitional cell carcinoma (TCC) of the bladder using a large international cohort. Methods: Univariate and multivariate logistic regression models targeted histologically confirmed disease recurrence, and focused on 2,542 patients with bladder TCC from 10 participating centers. Variables consisted of pre-cystoscopy voided urine Nuclear Matrix Protein 22 (NMP22) assay, urine cytology, age and gender. Resulting nomograms were internally validated with bootstrapping. Nomogram performance was explored graphically with Loess smoothing plots. Results:…

Predictive value of positive NMP22 in patients with negative cytology and cystoscopy.

Clinical Pitfalls in Diagnosis of Nonmuscle-Invasive Bladder Cancer

Current global economic crisis imposes healthcare system to reduce unnecessary investigations and increase early detection of tumors, to decrease the costs of an advanced disease. Several diagnostic pitfalls may occur dealing with bladder cancer (BC), particularly in nonmuscle-invasive (NMIBC) one. Hematuria, the commonest sign in NMIBC, is often underestimated. Urinary cytology is highly specific for high-grade tumors, but has a low sensitivity for low-grade BC, is operator dependent, and not always obtainable in clinical practice. Numerous urinary tests are available to ameliorate the accuracy of cytology, but none of them is routinly used in urological practice. Ultrasound could hardly …

THE IMPACT OF RE-TUR ON CLINICAL OUTCOMES IN A LARGE COHORT OF T1G3 PATIENTS TREATED WITH BCG.

Scopo del lavoro Re-TUR is strongly advocated for T1G3, because of the high incidence residual disease and mainly the risk of substaging. Its real clinical value remains to be determined and the clinical factors that may influence the decision. Some authors suggest that when muscle is present in the specimen, re-TUR may be avoided. To evaluate if the presence of muscle or not at the first TUR in T1G3 bladder cancer makes a difference in recurrence, progression and cancer specific survival after re-TUR. Materiali e metodi In a large retrospective cohort of 2530 primary T1G3 initially treated with BCG, 953 (37.7%) had a re-TUR. According to the presence or not of muscle in the specimen of pri…

Intravesical gemcitabine in superficial bladder tumors. Results of a phase I-II study

the good tolerability of intravesical gemcitabine have been recently published. The evaluation of the activity on a papillary marker lesion is the best tool to measure the efficacy of a drug by intravesical route against superficial transitional cell carcinoma of the bladder (TCCB). The scientific background and the ethical acceptability of this approach have been validated by the European Organization for Research and Treatment of Cancer Urological Group. The aim of the present study was to evaluate the ablative efficacy of weekly intravesical instillations of gemcitabine against a histologically proven papillary marker lesion. MATERIAL & METHODS: Twenty-seven patients, affected by recurre…

Diagnosi precoce del carcinoma prostatico in sicilia e calabria. Dati preliminare di uno studio osservazionale del GSTU e della SSCU.

Fattori di rischio ambientale nel carcinoma vescicale superficiale. Risultati su 577 pazienti sottoposti a chemioterapia endovescicale adiuvante.

Chronic Prostatitis and Prostatodynia: Ultrasonographic Alterations of the Prostate, Bladder Neck, Seminal Vesicles and Periprostatic Venous Plexus

Transrectal ultrasonography was performed in 121 patients with the chronic prostatitis syndrome (CPS), and in 20 patients with urological pathology not involving the prostate gland. The ultrasonographic aspects of the seminal vesicles (SV) in normal subjects and in patients with the CPS are described. In the latter group, characteristic ultrasonographic patterns can often be obtained, even in patients affected by prostatodynia, in whom all the other clinical and laboratory findings were absent. They consisted of: (a) dyshomogeneous echo-structure of the prostate; (b) constant dilatation of the periprostatic venous plexus, greater than 150 mm2; (c) dilated, elongated SV, with thickening of t…

MP43-14 COMPARISON BETWEEN QUINOLONES AND OTHER ANTIBIOTICS IN PREVENTING INFECTIVE COMPLICATIONS IN TRANSRECTAL PROSTATE BIOPSY

INTRODUCTION AND OBJECTIVE:Sepsis is one of the most feared complications of prostate biopsy: it’s incidence is 1-3%. Prevention of infection after biopsy procedure consists in prophylactic antibio...

Ottimizzazione del timing bioptico dopo primo riscronto di HG-PIN

The Prognostic Value of P53 in Predicting of Bladder Carcinoma

The prognostic value of p53 in predicting recurrence and progression of superficial transitional cell carcinoma of the bladder (TCCB) is still uncertain. Materials and methods P53 expression was retrospectively assessed in 160 patients. At a median follow-up of 45 months, (up to years) 84 patients (53%) recurred and 13 (8%) progressed. Adjuvant intravesical chemotherapy after TUR was adopted in 51 patients (32%). The correlations between p53 and G-grade, T-category, risk of recurrence and progression, and intravesical chemotherapy were investigated. Similarly, the correlations between variations in grade and stage at recurrence and modifications in p53 expression were also studied. Results…

Segmental ureterectomy vs. radical nephroureterectomy for ureteral carcinoma in patients with a preoperative glomerular filtration rate less than 90 ml/min/1.73 m2: A multicenter study

Objectives: To compare segmental ureterectomy (SU) and radical nephroureterectomy (RNU) in terms of overall survival (OS) and impact on postoperative renal function in patients treated for upper tract urothelial carcinoma (UTUC) of the ureter with preoperatively reduced estimated glomerular filtration rate (eGFR). Materials and methods: We retrospectively collected the data of consecutive patients treated for UTUC, in 6 Italian tertiary referral centers, from 2003 to 2013, and analyzed those treated with RNU or SU for ureteral cancer and with a preoperative eGFR &lt;90 ml/min/1.73m2. The primary outcome was to compare the postoperative eGFR variation and the OS according to the surgical tec…

Osservational Study on Early Diagnosis of Prostate Carcinoma in Sicily and Calabria

The diagnosis of prostate carcinoma has been monitored in Sicily and Calabria for one year. Material e Methods Twenty-seven urological centres of Sicily and Calabria joined the study. Detailed informations about age, familiarity, PSA, Gleason score and TNM stage at diagnosis were centralized between november 2001 and november 2002. Results 721 patients have been recruited. The median age was 73 years. More than 80% of the patients were older than 65 years. Median PSA was 14 ng/ml. The clinical stage at diagnosis was T1c in 33% of patients and 67% had an organ confined prostate cancer (T1-T2). Familiarity was detected in 8% of cases. Age and PSA at diagnosis in these patients were similar t…

Analisi delle varianti rare del carcinoma a cellule uroteliali della vescica nei Pazienti sottoposti a cistectomia radicale: impatto sulla prognosi.

Smoking cessation and outcome of patients affected by non muscle invasive bladder cancer (NMI-BC)

Introduction: Does a correlation exist between smoking cessation and recurrence of non muscle invasive bladder carcinoma (NMI-BC) after TUR and adjuvant intravescical chemotherapy? Up today just few retrospective studies tried to answer this question. There is evidence that quitting decreases the risk of recurrence but nowadays it is still controversial how and how long it takes from quitting to reduce the risk (1-3). The aim of the present study is to compare the recurrence rate in smokers, non smokers and former smokers and in particular to evaluate if and how the decision of quitting at diagnosis could change the patients’outcome. Patients and Methods: We retrospectively analyzed the out…

Superficial Bladder Cancer Therapy: A Review

Most bladder cancers present as a superficial disease, confined to the bladder mucosa or submucosal layer, without muscle invasion. Most superficial tumors have a propensity for recurrence after transurethral resection; some have a high risk for progression to muscle invasion. The treatment aim in superficial bladder cancer with intravesical therapy is three-fold: (1) eradicate existing disease, (2) prevention of recurrence, (3) prevention of tumor progression. The prognostic factors (tumor stage, grade, size, number and recurrence pattern) allow the stratification of tumors in different risk groups to plan treatment. Studies on pharmacokinetics have proved the efficacy of optimized drug de…

High-Grade T1 on Re-Transurethral Resection after Initial High-Grade T1 Confers Worse Oncological Outcomes: Results of a Multi-Institutional Study

The aim of this multicenter study was to investigate the prognostic impact of residual T1 high-grade (HG)/G3 tumors at re-transurethral resection (TUR of bladder tumor) in a large multi-institutional cohort of patients with primary T1 HG/G3 bladder cancer (BC).

STUDIO RANDOMIZZATO SUL RUOLO DEL MANTENIMENTO NELLA CHEMIOPROFILASSI ENDOVESCICALE PRECOCE DOPO TUR CON EPIRUBICINA

Prognostic Factors And Risk Groups In T1g3 Patients Initially Treated With Bcg: Results Of A Multicenter Retrospective Series In 2530 Patients

INTRODUCTION AND OBJECTIVES: The impact of prognostic factors in T1G3 patients (pts) is critical for proper treatment decision making, however most available data are from small series of pts. The aim of the current study is to assess prognostic factors in a large group of pts who received BCG as initial treatment of T1G3 tumours and identify a subgroup of high risk pts who should be considered for early cystectomy. METHODS: Individual pt data were collected for 2530 pts from 23 centers who received induction or maintenance BCG between 1990 and 2008. Using Cox regression analysis, the prognostic importance of the following variables were assessed for time to recurrence, progression to muscl…

BASI SCIENTIFICHE PER LA DEFINIZIONE DI TERAPIA DELLE NEOPLASIE SUPERFICIALI.

Mitomycin C from birth to adulthood.

Mitomycin C (MMC) intravesical therapy for “superficial” papillary bladder tumors was firstly introduced in the early seventies with promising results. In the following years, several pharmacokinetic studies investigated its mechanism of action to optimize the intravesical administration. Numerous studies confirmed thereafter both the ablative and the prophylactic efficacy and the low toxicity of MMC when intravesically given. In 1984, a complete response rate of 42% in 60 patients not responsive to thiotepa was reported with intravesical MMC at the dose of 40 mg diluted in 40 ml for 8 weeks. In the following decades, many large randomized studies showed the benefit of intravesical prophyla…

La terapia dei tumori vescicali superficiali: lo stato attuale

Acute and late toxicity and preliminary outcomes report of moderately hypofractionated helical tomotherapy for localized prostate cancer: a mono-institutional analysis

Aims: To assess toxicity and clinical outcomes of moderately hypofractionated helical tomotherapy (HT) for the curative treatment of localized prostate cancer (PC). Methods: From December 2012 to May 2018, 170 patients were treated with definitive intent for PC. Thirty-four percent were low risk, 30% intermediate risk (IR) and 36% high risk (HR). All patients received 70 Gy in 28 fractions to the prostate; 61.6 Gy were delivered to the seminal vesicles for IR; pelvic lymph nodes irradiation for a total dose of 50.4 Gy was added in the HR subgroup. Toxicity was assessed using CTCAE V4.0, and biochemical failure was defined following Phoenix criteria. Time-to-event data were analyzed using th…

Correlation between leptin plasmatic levels in non-obese patients and detection rate at prostate biopsy”- Poster P147

Serum levels of angiogenetic cancer biomarkers in men undergoing prostate biopsy. Preliminary data

Background: The reduction of the number of negative prostate biopsies in patients with elevated serum PSA represents a major challenge. Several angiogenetic biomarkers are involved in carcinogenesis and cancer progression. The aim of our preliminary study was to investigate if their serum levels might be related to prostate cancer detection. Patients and Methods: Angiopoietin 2, Follistatin, G-CSF, HGF, IL-8, Leptin, PDGF- BB, PECAM-1, VEGF, PTH were the selected biomarkers for our research. They were measured by BioPlex immunoassay. As a preliminary step, consecutive unselected patients undergoing prostate biopsy for palpable prostate nodule and/or elevated PSA levels were entered. A 12-co…

STUDIO DI FASE II: DOCETAXEL SETTIMANALE COME SECONDA LINEA CHEMIOTERAPICA NEL CARCINOMA PROSTATICO AVANZATO

PROPHYLACTIC BLADDER INSTILLATIONS WITH IALURIL (R) MAY REDUCE SYMPTOMS OF ACUTE RADIATION CYSTITIS IN PATIENTS UNDERGOING RADIOTHERAPY FOR PELVIC TUMOURS

Introduction: Acute radiation cystitis (RC) is a common and debilitating problem in patients undergoing radiotherapy for urogenital malignancies. Acute RC symptoms include painful micturition, urgency, frequency, and nicturia We studied the feasibility and efficacy of intravesical instillations with Ialuril® (sodium hyaluronate and chondroitin sulfate sterile solution) to reduce acute radiation cystitis in men and women undergoing pelvic radiotherapy. Materials and Methods: The single-arm study was performed between September 2010 and June 2011 and included 15 patients who met the following criteria: primary or adjuvant radiotherapy for pelvic cancer. Exclusion criteria were: bladder cancer…

Comment On: Study on the Effects of Allitride and its Mechanisms on Renal Cell Carcinoma in Vitro

A randomized trial comparing tamoxifen therapy vs. tamoxifen prophylaxis in bicalutamide-induced gynecomastia.

BACKGROUND: Tamoxifen (TAM) has been shown to be active against the bicalutamide-induced breast events (BEs) gynecomastia, and breast pain in patients with prostate cancer (PC). Optimal doses and schedules are not yet established. Debate still exists about whether prophylaxis with TAM is more effective than treatment of BEs when diagnosed. The results of a randomized study comparing TAM prophylaxis vs. TAM therapy are presented. METHODS: One hundred seventy-six patients with prostate cancer (PC) who were candidates for bicalutamide monotherapy were randomized to receive TAM 20 mg daily orally within 1 month from the onset of BEs (arm A) vs. TAM 10 mg daily starting simultaneously with bical…

Intravesical mitoxantrone in superficial bladder tumours (Ta-T1)

Abstract 36 patients with histologically proven grade G1–G2, Ta-T1 transitional cell carcinoma of the bladder were introduced, after transurethral resection (TUR), into a study of intravesical chemoprophylaxis with mitoxantrone (20 mg diluted in 50 ml). After a mean follow-up of 23 months, 16 (50%) patients showed a superficial recurrence with a mean recurrence rate of 0.56 per year. In 19 patients with recurring tumours the mean recurrence rate decreased from 1.65 to 0.58 per year. 9 patients (25.7%) suffered from a chemical cystitis that in 2 cases (5.7%) required treatment interruption.

FIBRONECTIN (FN) AND UROTHELIAL DAMAGE SECONDARY TO ADJUVANT INTRAVESICAL THERAPY

Introduction and Objectives: Intravesical chemotherapy has been proven effective in preventing recurrence of low-risk non-muscle invasive bladder cancer (NMIBC). BCG is recognised as the best conservative treatment for intermediate and high risk NMIBC. Maintenance for at least one year is required to ameliorate the efficacy of adjuvant therapy. Discomfort and toxicity often cause interruption of adjuvant therapy, BCG particularly. Almost 50% of the patients undergoing BCG does not complete one year. A biomarker of urothelium damage would be helpful for timely detection of toxicity in order to ameliorate patient’s tolerance and compliance. The aim of the present study was to evaluate the gen…

WHATSAPP MESSENGER AS A REAL-TIME TOOL FOR A LONG-DISTANCE ACTIVITY OF A MULTIDISCIPLINARY

Variations PSA Value in Patients Candidate to Biopsy of the Prostate

Subclinical infections of the prostate can increase the prostate-specific antigen (PSA) values in patients with normal digital rectal examination. This study aimed to evaluate the role of short-term antimicrobial therapy in reducing the PSA value in patients as candidates for transrectal biopsy. Fifty-eight patients with negative digital rectal examination and PSA values between 4 and 20 ng/mL were included in the study. Antibiotics were administered to all patients for 3 weeks, and the PSA was reassessed 10 days after the end of the treatment. Patients were subsequently submitted to prostate biopsy. A reduction in PSA was detected in 34 patients (59%). Mean percentage reduction was 32%. I…

The genitourinary diseases health-care among patients and general practitioner

Introduction: A general awareness of the most common genitourinary diseases is often lacking.The aim of the present study was to investigate the attention of the general practitioner and of the patient to the genitourinary diseases. An incomplete medical history and/or an inadequate physical examination might be responsible of late diagnosis and improper management. Patients and Methods: A self administered questionnaire was obtained by our outpatients before the urological visit. As a preliminary step we administered a very simple questionnaire consisting of four multiple choice questions: 1) Did your general practitioner examine your external genitalia in the last five years? Did you ask …

Intravesical gemcitabine is superficial bladder tumours. Results of a phase I-II study

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CORRELATION BETWEEN FIBRONECTIN GENE EXPRESSION AND LOCAL TOXICITY INDUCED BY ADJUVANT INTRAVESICAL THERAPY

Nomograms for bladder cancer recurrence according to grade and stage

Oral chemotherapy in hormone-refractory prostate carcinoma patients unwilling to be admitted to hospital.

&lt;i&gt;Objectives:&lt;/i&gt; To investigate the safety and efficacy in terms of PSA response of a low-dose oral combination of estramustine phosphate (EMP) and etoposide (VP16) in hormone- refractory prostate cancer (HRPC) patients. Well-tolerated outpatient chemotherapy regimens for patients unfit and/or unwilling to be admitted to hospital are needed. &lt;i&gt;Methods:&lt;/i&gt; Fifty-six HRPC patients with metastatic disease (median age 75 years) were randomized between arm A (daily oral EMP 10 mg/kg, in 3 doses) and arm B (28-day cycle with low-dose EMP 3 mg/kg once daily plus VP16 25 mg/m&lt;sup&gt;2&lt;/sup&gt; once daily on days 1 through 14). Baseline characteristics between the t…

ESTRAMUSTINA FOSFATO VS ASSOCIAZIONE A BASSA DOSE DI ESTRAMUSTINA FOSFATO E ETOPOSIDE NEL CARCINOMA PROSTATICO ORMONOREFRATTARIO (HRPC). STUDIO RANDOMIZZATO DI FASE II DEL GRUPPO STUDI TUMORI UROLOGICI (GSTU)

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Fibronectin (FN), epidermal growth factor-receptor (EGF-R) and heparin-binding epidermal growth factor-like (HB-EGF) urinary expressions and topical toxicity of adjuvant intravesical therapy for non muscle invasive bladder cancer (NMI-BC)

NMI bladder cancer, EGF-R, intravesical therapy. fibronectin

THE ROLE OF INTRAVESICAL GLYCOSAMINOGLYCANS IN TOXICITY INDUCED BY ADJUVANT INTRAVESICAL THERAPY: GENETIC LABORATORY EVIDENCE

Le prostatiti.

Environmental Risk Factors in Superficial Bladder Cancer

As a preliminary approach to define the object of larger case-control studies, the distribution of potential risk factors coming from environmental pollution among patients affected by superficial bladder cancer (TCCB) has been analyzed. Material e Methods. The analysis included only patients affected by medium risk superficial TCCB. Forty Italian urological centres joined the study. Detailed information about age, sex, residency, employment, active and passive cigarette smoking, water resource, hair-dye use were centralized. All patients underwent TUR and early intravesical chemotherapy. The distribution of the above mentioned environmental factors was related to tumor characteristics suc…

Correlation between GP-170 expression, prognosis, and chemoresistance of superficial bladder carcinoma.

To study GP-170 in superficial bladder cancer at initial diagnosis and at recurrence and to evaluate if intravesical chemoprophylaxis modifies the expression of GP-170 in tumor recurrences. GP-170 was retrospectively assessed in 160 patients affected by primary superficial transitional cell carcinoma of the bladder and followed for up to 10 years. Eighty-four patients (52.5%) recurred after transurethral resection (TUR). Adjuvant intravesical chemotherapy after TUR was adopted in 52 patients. The correlations between GP-170 and G-grade, T-category, risk of recurrence and of progression, and adoption of adjuvant intravesical chemotherapy were investigated. The correlations between variations…

High risk Gleason patterns at prostate biopsy and body mass index.

FIBRONECTINA: NUOVO MARKER DI DANNO UROTELIALE NELLA TERAPIA ADIUVANTE INTRAVESCICALE DEI TUMORI VESCICALI NON MUSCOLO INVASIVI

Efficacy of one-year maintenance in early adjuvant chemotherapy for intermediate risk non-muscle-invasive bladder cancer. Preliminary results of a randomized cooperative trial.

Introduction and Objective: The clinical value of early intravesical adjuvant chemotherapy after TUR of intermediate risk non-muscle-invasive bladder cancer (NMI TCCB) is well established. On the other hand, the optimal schedule regimen and the role of maintenance are still debated. The aim of the present study was to evaluate the effectiveness of one-year maintenance schedule in patients submitted to TUR plus adjuvant early intravesical chemotherapy. Methods: Between May 2002 and August 2003, 577 patients, were recruited. All patients underwent TUR and early (within 6 hours) intravesical chemotherapy with epirubicin at the dose of 80 mg diluted in 60 ml of saline solution. When histology w…

[Clinical practice and adherence to the diagnosis and treatment of NMIBC guidelines: a report of a recognition based clinical cases study]

For non-muscle invasive bladder cancer, a disease with a considerable epidemiological and socio-economic impact, the introduction of the Guidelines has always evoked as a tool for the resolution of long-standing disputes in terms of diagnosis and therapy. Check the degree of routine clinical practice adherence to the Recommendations is for this disease, more than for other uro-oncology pathology, an urgent need felt by the urological community. To assess the level of Guidelines adherence's, and study issues related to the paths of diagnosis and treatment of non-muscle invasive bladder cancer, and identifying the processes actually implemented in daily clinical practice, a series of case st…

Fattori di rischio ambientale nel carcinoma vescicale superficiale. Risultati su 577 pazienti sottoposti a chemioterapia endovescicale adiuvante

Ruolo della terapia di mantenimento e fattori di rischio ambientale nel carcinoma vescicale superficiale. Pazienti sottoposti a chemioterapia endovescicale adiuvante. Risultati preliminari di uno studio randomizzato su 577 pazienti.

Environmental factors in superficial bladder cancer. Preliminary report of a prospective study

PATIENT’S COMPLIANCE TO INTRAVESCICAL BCG IN ROUTINE CLINICAL PRACTICE, RETROSPECTIVE ANALYSIS OF 411 CONSECUTIVE PATIENTS.

Aim of the study BCG maintenance for at least one year is advocated by urological guidelines as the best intravesical regimen in high-risk non muscle invasive bladder cancer (NMIBC), conservatively treated. Noteworthy, a relevant percentage of patients does not complete the planned treatment even if toxicity accounted for less that 10% of drop outs in recent multi-institutional trials. The aim of this study was to analyze the reasons for treatment interruption in everyday clinical practice. Materials and methods Consecutive patients affected by T1HG NMIBC undergoing conservative management with adjuvant BCG entered the study. The Connaught BCG strain was administered intravesically, at the …

Manuale di Urologia e Andrologia. Capitolo 1: Anatomia dell'apparato genito-urinario

LOWER RESPONSE TO INTRAVESICAL ADJUVANT THERAPY IN HIGH-RISK BLADDER CANCER COULD BE RELATED TO THE UROTHELIAL EXPRESSION OF EGFR

Chemioterapia domiciliare nel carcinoma prostatico ormonorefrattario (HRPC). Studio di fase II del gruppo studio tumori urologici (GSTU).

LIMITS OF TRANSURETHRAL RESECTION IN DETECTING RARE HISTOLOGICAL VARIANTS WITHIN LARGE UROTHELIAL BLADDER TUMORS

PREDICTING BLADDER CANCER AT THE EMERGENCY UNIT: THE IMPACT OF HEMOGLOBIN VALUE

Aim of the study Haematuria represents the most common symptom at presentation in patients with bladder Cancer (BCa). However, no study has tested the predictors of BCa in patients presenting with haematuria. This prospective study was aimed to assess the factors associated with the presence of BCa in patients presenting at our emergency unit due to gross-hematuria. Materials and methods All patients presenting at the emergency unit of our institution for their first episode of gross haematuria between January and December 2012 were evaluated. All clinical patient characteristics, including the ongoing antiplatelets and/or oral anticoagulative treatment, were recorded. Demographical, hemato…

Studio randomizzato sul ruolo del mantenimento nella chemioprofilassi endovescicale precoce dopo TUR con Epirubicina. XVI Congresso Nazionale Società Italiana di Urologia Oncologica. 30 Novembre - 3 Dicembre 2006. Arch. Ital. Urol. Androl. vol. , pp. 71. ISBN/ISSN: 1124-3562.

VARIANT HISTOLOGIC DIFFERENTIATION IN BLADDER CANCER TREATED WITH RADICAL CYSTECTOMY: INCIDENCE AND LONG TERM SURVIVAL IN A SINGLE INSTITUTION STUDY.

Radium-223 treatment in castration resistant bone metastatic prostate cancer. Should be the primary tumor always treated?

Introduction: Radium-223 (223Ra) improves symptoms and survival in patients with bone metastatic castration-resistant prostate cancer (mCRPC). Study aim: To evaluate the impact of a previous radical prostatectomy (RP) on the outcome of 223Ra therapy in mCRPC patients. The primary prostate tumor left untreated could progress during 223Ra treatment. Materials and methods: mCRPC symptomatic patients treated with 223Ra were enrolled. Luteinizing Hormone-Releasing Hormone analogue was maintained. No other anticancer therapy was given. 223Ra was administered i.v. at the dose of 55 kBq/kg every 4 weeks for 6 cycles. Patients were stratified according to previous RP or not. Hematological toxicity w…

Modified Glasgow Prognostic Score is Associated With Risk of Recurrence in Bladder Cancer Patients After Radical Cystectomy

Recently, many studies explored the role of inflammation parameters in the prognosis of urinary cancers, but the results were not consistent. The modified Glasgow Prognostic Score (mGPS), a systemic inflammation marker, is a prognostic marker in various types of cancers. The aim of the present study was to investigate the usefulness of the preoperative mGPS as predictor of recurrence-free (RFS), overall (OS), and cancer-specific (CSS) survivals in a large cohort of urothelial bladder cancer (UBC) patients.A total of 1037 patients with UBC were included in this study with a median follow-up of 22 months (range 3-60 months). An mGPS = 0 was observed in 646 patients (62.3%), mGPS = 1 in 297 pa…

PSA E PROSTATITE CRONICA CLINICAMENTE SILENTE IN PZ CON SOSPETTO CARCINOMA PROSTATICO T1C

Does hyperthermia improve the results of intravesical chemotherapy?

FEASIBILITY OF EGFR EVALUATION IN BLADDER WASHINGS OF PATIENTS AFFECTED BY NON MUSCLE-INVASIVE BLADDER CANCER.

A 1-year maintenance after early adjuvant intravesical chemotherapy has a limited efficacy in preventing recurrence of intermediate risk non-muscle-invasive bladder cancer

Study Type – Therapy (RCT) Level of Evidence 1b OBJECTIVE To evaluate the efficacy of 1-year maintenance after a 6-week cycle of early intravesical chemotherapy, as the role of maintenance in intravesical chemotherapy is debated. PATIENTS AND METHODS Between May 2002 and August 2003, 577 patients with non-muscle-invasive bladder cancer (NMI-BC) underwent transurethral resection (TUR) and early intravesical chemotherapy (epirubicin, 80 mg/50 mL). They were randomized between a 6-week induction cycle and the induction cycle plus maintenance with 10 monthly instillations. In all, 95 patients with T1G3, Tis or single and primary Ta–T1 G1–G2 tumours were excluded; 482 patients at intermediate ri…

PSA and second-line therapy of hormone refractory prostate carcinoma

The aim of the present study was to correlate PSA response with subjective response (bone pain and performance status), in patients treated for hormone refractory carcinoma of the prostate. Twenty-four patients were introduced into the study. Median PSA was 198 ng/ml. Symptom score, performance status and PSA were monitored monthly for 3 months and then 3-monthly. Sixteen patients (66%) showed a PSA response (median value 10 ng/ml). In 8 patients (33%) PSA was 4 ng/ml. In conclusion, PSA response is not always related to subjective improvement and does not always implicate a beneficial effect of the therapy for the patient. Copyright © 2001 S. Karger AG, Basel.

Correlation between clinical response and urinary interleukin levels using different doses and intravesical administration schedules of interferon-alpha-2b combined with epirubicin: a pilot study

A total of 62 patients at high risk for recurrence of superficial bladder cancer were selected for a study designed to compare the prophylactic efficacy of different doses and schedules of sequential intravesical instillations of epirubicin and interferon-alpha-2b and to evaluate which sequence could enhance the release of cytokines in the urine. Our investigations showed a significant increase in urinary concentrations of interleukins in patients who received the sequential intravesical administration of epirubicin and interferon-alpha-2b. Higher urinary concentrations of interleukins and a lower recurrence rate were detected in patients who received interferon-alpha-2b 24 h after epirubic…

An increased body mass index is associated with a worse prognosis in patients administered BCG immunotherapy for T1 bladder cancer

PURPOSE: The body mass index (BMI) may be associated with an increased incidence and aggressiveness of urological cancers. In this study, we aimed to evaluate the impact of the BMI on survival in patients with T1G3 non-muscle-invasive bladder cancer (NMIBC). METHODS: A total of 1155 T1G3 NMIBC patients from 13 academic institutions were retrospectively reviewed and patients administered adjuvant intravesical Bacillus Calmette-Guérin (BCG) immunotherapy with maintenance were included. Multivariable Cox regression analysis was performed to identify factors predictive of recurrence and progression. RESULTS: After re-TURBT, 288 patients (27.53%) showed residual high-grade NMIBC, while 867 (82.8…

Cigarette smoking and drinking water source: Correlation with clinical features and pathology of superficial bladder carcinoma.

Cytokines gene expression in the tunica albuginea in patients with Peyronie’s disease. Pilot study with a control group

INTRODUCTION: We decided to conduct a study to investigate the presence of cytokines in the albuginea of subjects with Peyronie's disease (PD). Cytokines, as responsible for intercellular communication, maybe involved in the pathogenesis of the disease. The identification of one or more involved cytokines may, in fact, be useful in the pharmacological treatment with biologic drugs that are able to interfere with specific cytokines. MATERIALS AND METHODS: Between January 2009 and Decembre 2010 at the Clinic of Urological outpatients clinic of the Policlinico of Palermo were recruited 20 subjects with PD, mean age 62.3 years (range 51-70) and 8 subjects with congenital recurvatum penis (mean …

Wuhan, the second MPAU meeting: our society is progressing

Efficacia del mantenimento nella chemioprofilassi endovescicale precode dopo TUR. Risultati di uno studio randomizzato multicentrico.

Prognostic factors and risk groups in T1G3 non-muscle-invasive bladder cancer patients initially treated with Bacillus Calmette-Guérin: results of a retrospective multicenter study of 2451 patients.

Contains fulltext : 153742.pdf (Publisher’s version ) (Closed access) BACKGROUND: The impact of prognostic factors in T1G3 non-muscle-invasive bladder cancer (BCa) patients is critical for proper treatment decision making. OBJECTIVE: To assess prognostic factors in patients who received bacillus Calmette-Guerin (BCG) as initial intravesical treatment of T1G3 tumors and to identify a subgroup of high-risk patients who should be considered for more aggressive treatment. DESIGN, SETTING, AND PARTICIPANTS: Individual patient data were collected for 2451 T1G3 patients from 23 centers who received BCG between 1990 and 2011. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Using Cox multivariable re…

Validation of Neutrophil-to-lymphocyte Ratio in a Multi-institutional Cohort of Patients With T1G3 Non–muscle-invasive Bladder Cancer

The aim of this multicenter study was to investigate the prognostic role of neutrophil-to-lymphocyte ratio (NLR) and to validate the NLR cutoff of 3 in a large multi-institutional cohort of patients with primary T1 HG/G3 non-muscle-invasive bladder cancer (NMIBC).

CHEMIOPROFILASSI PRECOCE CON EPIRUBICINA AD ALTA DOSE NEL CARCINOMA VESCICALE SUPERFICIALE. STUDIO RANDOMIZZATO DEL GSTU

Risultati a lungo termine del trattamento con TUR e terapia endovescicale adiuvante nell’urotelioma vescicale T1G3. Recidiva, progressione e sopravvivenza in 236 pazienti

Moderate hypofractionated helical tomotherapy for prostate cancer in a cohort of older patients: a mono-institutional report of toxicity and clinical outcomes.

Purpose or objective: To evaluate toxicity and outcomes of moderately hypofractionated helical tomotherapy for the curative treatment of a cohort of patients aged ≥ 75 years with localized prostate cancer (PC). Materials and methods: From January 2013 to February 2017, 95 patients with median age 77 years (range 75–88) were treated for PC. 39% were low risk, 33% intermediate risk (IR), 28% high risk (HR). Median iPSA was 9.42 ng/ml (1.6–107). Androgen deprivation was prescribed according to NCCN recommendations. All patients received 70 Gy in 28 fractions to the prostate; 61.6 Gy were delivered to the seminal vesicles for IR; whole pelvis irradiation with a total dose of 50.4 Gy was added i…

Studio randomizzato multicentrico: mantenimento mensile per un anno versus induzione per 6 settimane nella chemioprofilasi precoce dopo TUR.

IS IT POSSIBLE TO PREDICT CHEMORESISTANCE OF SUPERFICIAL BLADDER CARCINOMA?

Correlation between BMI and the pathological features of prostate cancer at biopsy

Introduction/Aim: Numerous clinical trials investigated the association between obesity and prostate cancer, but they yielded inconsistent results (1). Obesity has been found to be related to prostatic tumors at more advanced stages and higher Gleason grade when compared with normal population (2). An increased number of biopsy cores has been advocated by some Authors in obese and overweight men due to an increased difficulty and delay in cancer detection (3). The main aim of our research was to correlate Body Mass Index (BMI) with the pathological characteristics of prostate cancer at biopsy. Patients and Methods: Patients with positive prostate biopsy performed for palpable prostate nodul…

Antiandrogens alone or in combination for treatment of prostate cancer: The European experience

Abstract In Europe, antiandrogens have been used for many years to treat prostate cancer, either as monotherapy or as part of a “combination therapy” with either surgical or chemical castration. However, considerable debate still exists regarding the relative benefits of combination therapy versus antiandrogen monotherapy or castration alone. This article reviews the European experience with antiandrogen therapy, including the personal experiences of the authors.

RECURRENCE AND PROGRESSION ACCORDING TO STAGE AT RE-TUR IN T1G3 BLADDER CANCER PATIENTS TREATED WITH BCG: NOT AS BAD AS PREVIOUSLY THOUGHT

Prostatite clinicamente silente (INH IV) ed elevazione del PSA.

Characterization of human infiltrating and circulating gamma-delta T cells in prostate cancer

Purpose The aim of our study was to prospectively evaluate the distribution of gamma-delta (γδ)1 and γδ2 T cells and their phenotypes in peripheral blood and prostate samples of patients diagnosed with or without prostate cancer (PCa) at prostate biopsy. Materials and methods A consecutive series of 43 outpatients underwent trans-rectal echo-guided prostate biopsy for suspected PCa. Flow cytometry analysis was used to identify and characterize the γδ T cells populations in peripheral blood and tissue samples. Patients were stratified according to the presence or not of PCa, and its International Society of Urological Pathology (ISUP) grade (1 vs. ≥2). Results The distribution of γδ T cells …

PLASMATIC SIL 6R/IL-6 RATIO AS APOTENTIAL PREDICTOR OF HIGH GLEASON SUM AT RADICAL PROSTATECTOMY

Background: Approximately 40% of males with low Gleason grade clinically localized prostate cancer (PCa) at biopsy were finally diagnosed with high Gleason grade PCa at radical prostatectomy (RP). Therefore, a more reliable assessment of the Gleason grade prior to RP is required. Readily available modalities such as circulating biomarkers may be useful for this purpose. The aim of this study was to evaluate the ability of preoperative interleukin 6 (IL-6) and its soluble receptor (sIL-6R), as well as urokinase-type plasminogen activator (u- PA), its receptor (u-PAR) and the inhibitor (PAI-1) to predict Gleason score upgrading. Patients and Methods: A total of 51 PCa patients with biopsy Gle…

CHOICE OF ADJUVANT INTRAVESICAL THERAPY IN RECURRING INTERMEDIATE-RISK NMI-BC

Objective: The therapeutic strategy for patients affected by intermediate risk non-muscle invasive bladder cancer (NMIBC) recurring after intravesical therapy is not definitively established. Only few studies have been published on secondline intravesical therapy. BCG is advocated when intravesical chemotherapy fails and is often repeated. On the other hand, some patients that suffer recurrence repeat intravesical chemotherapy. A retrospective analysis of 179 intermediaterisk patients submitted to second-line intravesical therapy is reported. Patients and Methods: The clinical files of patients affected by intermediate risk NMI-BC and submitted to second-line adjuvant intravesical therapy w…

Clinical implications of a rare renal entity: Pleomorphic Hyalinizing Angiectatic Tumor (PHAT)

Abstract Pleomorphic Hyalinizing Angiectatic Tumor (PHAT) is a rare benign lesion characterized by slow growth, infiltrative behavior and high rate of local recurrences. Only one case has been described in retroperitoneum, at renal hilum, but not involving pelvis or parenchyma. Here we present the first case of PHAT arising in the renal parenchyma. A nodular lesion in right kidney lower pole was diagnosed to a 61 year old woman. The patient underwent right nephrectomy. Microscopically, the lesion showed solid and pseudo-cystic components with hemorrhagic areas characterized by aggregates of ectatic blood vessels. Pleomorphic cells were characterized by large eosinophilic cytoplasm with irre…

Studio pilota sul valore predittivo dei livelli plasmatici di 9 fattori angiogenetici nella selezione di pazienti candidati alla biopsia prostatica

To reduce the number of negative prostate biopsies in patients with elevated PSA serum levels represents a major challenge in urological oncology. Angiogenetic factors might be involved in initial stages of prostate cancer and might represent useful tools in patients' selection for prostate biopsy. The plasmatic levels of Angiopoietin-2, Follistatin, G-CSF, HGF, IL-8, Leptin, PDGF-BB, PECAM-1 and VEGF were measured by BioPlex immunoassay in patients undergoing prostate biopsy for palpable prostate nodule and/or elevated PSA levels (≥4 ng/mL). They were related with biopsy results. ROC curve analysis was exploited to test the diagnostic accuracy of each biomarker by AUC calculation. A potent…

VISCERAL FAT TISSUE ACTIVITY DOES NOT CORRELATE TO HIGH GRADE PROSTATE CANCER RISK AT BIOPSY

Although rare, severe complications following intravesical bacillus Calmette-Guerin treatment should not be overlooked!

An interesting series of 22 patients affected by severe systemic toxicity following bacillus Calmette-Guerin (BCG) intravesical adjuvant therapy for bladder cancer is presented in this issue of Inf...

Urinary cytology and nuclear matrix protein 22 in the detection of bladder cancer recurrence other than transitional cell carcinoma

OBJECTIVE: To assess the value of nuclear matrix protein-22 (NMP22), compared with urinary cytology, in predicting the recurrence of bladder cancer that is not transitional cell carcinoma (non-TCC). PATIENTS AND METHODS: We tested the sensitivity, specificity and the predictive accuracy of NMP22 in the context of non-TCC bladder cancer recurrence, and compared it to the performance of urinary cytology. The study group comprised 2687 patients with history of non-muscle-invasive bladder cancer from 10 centres across four continents. RESULTS: The mean patient age was 64.8 years and 75.4% were men; of all patients, 513 (19.1%) had positive urinary cytology, 906 (33.7%) had a positive NMP22 test…

A case of renal carcinoma metastasis simulating a thyroid goiter

Background: Although the thyroid is a highly vascularized gland, it is not a common target of metastasis from extrathyroidal cancer. Clear-cell renal carcinoma (cRCC) frequently metastasizes to the thyroid, representing 2-3% of all adult tumors, and more than 40% of patients present with metastases at diagnosis. The presence of cRCC thyroidal metastases makes the differential diagnosis from thyroid clearcell carcinoma extremely difficult. Patients and Methods: A 70-year-old woman presented with a mild compressive symptomatology due to a recent multinodular thyroid goiter with a ‘simple’ multinodular ultrasound pattern, in the absence of signs of malignancy and with normal findings for hormo…

Sindromi prostatitiche croniche (SPC), Chronic Pelvic Pain Syndrome e cistite interstiziale. Semplice analogia o unità patogenetica? Risultati di uno studio pilota sul trattamento delle SPC con associazione di un anti-istaminico ed un eparinoide.

Tumori della Vescica

IMPACT OF THE SITE OF RECURRENCE AFTER RADICAL CYSTECTOMY ON SURVIVAL: DIFFERENT SITES FOR DIFFERENT OUTCOMES

Sildenafil orodispersible film in the treatment of erectile dysfunction after radical prostatectomy: A single‐centre open‐label uncontrolled trial

Phosphodiesterase-5 inhibitors are the first-line therapy for erectile dysfunction (ED) after radical prostatectomy (RP). This single-centre open-label uncontrolled study evaluated the efficacy and safety of the new sildenafil orodispersible film (ODF) in ED treatment after RP. Sildenafil 100 mg ODF was administered twice a week for 3 months to patients under 75 years of age, with a Framingham cardiovascular risk score &lt; 20% and a pre-operative International Index of Erectile Function (IIEF)-5 score ≥ 17, who had undergone open RP between 2016 and 2018. Erectile function was assessed pre-operatively, post-operatively and after treatment through the IIEF-5 score, the Sexual Encounter Prof…

Adjuvant Intravesical Chemotherapy in Patients with Primary T1 G3 Transitional Cell Carcinoma of the Bladder

The Authors present their experience with TUR plus adjuvant intravesical chemotherapy in 50 patients affected by primary T1 G3 bladder tumours without previous or concomitant carcinoma in situ. At a mean follow-up of 36 months, 84% of the patients are alive and tumour-free. Cystectomy was performed in three patients due to locally invasive disease. Five patients (10%) died of bladder cancer.

The efficacy of BCG TICE and BCG Connaught in a cohort of 2,099 patients with T1G3 non–muscle-invasive bladder cancer

BACKGROUND Potential differences in efficacy of different bacillus Calmette-Guerin (BCG) strains are of importance for daily practice, especially in the era of BCG shortage. OBJECTIVE To retrospectively compare the outcome with BCG Connaught and BCG TICE in a large study cohort of pT1 high-grade non-muscle-invasive bladder cancer patients. DESIGN, SETTING, AND PARTICIPANTS Individual patient data were collected for 2,451 patients with primary T1G3 tumors from 23 centers who were treated with BCG for the first time between 1990 and 2011. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Using Cox multivariable regression and adjusting for the most important prognostic factors in this nonrandomiz…

Effect on postoperative survival of the status of distal ureteral margin: The necessity to achieve negative margins at the time of radical cystectomy.

Background: Despite several studies, the adequate management of positive distal ureter margins at the time of radical cystectomy (RC) remains controversial. Particularly, it is not clear whether the achievement of negative distal ureter margins at the intraoperative frozen sections (IFS) affects postoperative cancer-specific mortality (CSM). Methods: In all, 1,447 consecutive patients treated with RC at a single center between January 1987 and August 2014 were considered. Multivariable (MVA) logistic regression analyses were used to determine predictors of positive IFS. MVA Cox regression analyses were used to test the effect on CSM of intraoperative conversion to negative margins. Results:…

TERAPIA CONSERVATIVA CON TUR E TERAPIA ENDOVESCICALE ADIUVANTE IN UNA POPOLAZIONE SELEZIONATA DI PAZIENTI AFFETTI DA CARCINOMA VESCICALE T1G3

Fibronectin (FN), Epidermal Growth Factor-Receptor (EGF-R) and Heparin-Binding Epidermal Growth Factor-Like Growth Factor (HB-EGF) expressions in relation to toxicity of adjuvant intravesical therapy for non-muscle invasive bladder cancer.

IS VISCERAL ADIPOSITY INDEX (VAI)RELATED TO PROSTATE CANCER DETECTED BY BIOPSY?

association between obesity and prostate cancer, yielding inconsistent results. Metabolic syndrome has been suggested to promote aggressive prostate tumors. In a previous study we failed to detect a relation between Body Mass Index (BMI) and prostate cancer Gleason score (1). BMI, although routinely adopted to measure obesity, has low sensitivity and specificity. A novel sex-specific obesity index, based on waist circumference (WC), BMI, triglycerides (TGs) and high density lipoproteins (HDL), the Visceral Adiposity Index (VAI), has been proposed to estimate the visceral adiposity dysfunction (2). The aim of our preliminary research was to correlate VAI and BMI with the presence of prostate…

RISULTATI DI UNO STUDIO RANDOMIZZATO SULLA TOSSICITÀ E SUL RUOLO DEL MANTENIMENTO NELLA CHEMIOPROFILASSI ENDOVESCICALE PRECOCE DOPO TUR DI CARCINOMA VESCICALE SUPERFICIALE

Il regime di mantenimento potenzia l’efficacia della chemioprofilassi endovescicale precoce e induzione settimanale nei confronti delle recidive degli uroteliomi vescicali a rischio intermedio.? Risultati di uno studio multicentrico.

SCOPO DEL LAVORO: Malgrado l’efficacia della chemioterapia endovescicale eseguita precocemente dopo la resezione endoscopica di uroteliomi vescicali NMI sia stata confermata da numerosi studi multicentrici, ancora dubbio rimane il ruolo di un ulteriore schema terapeutico di mantenimento nel potenziarne l’efficacia. Ciò rimane ancora più incerto se alla singola instillazione segue un ciclo di instillazioni settimanali. Scopo dello studio è stato valutare l’utilità di uno schema di mantenimento mensile per un anno rispetto alla sola induzione settimanale per 6 settimane in pazienti sottoposti a TUR e chemioprofilassi precoce con epirubicina. MATERIALI E METODI: Sono stati randomizzati 577 paz…

How Can the COVID-19 Pandemic Lead to Positive Changes in Urology Residency?

The COVID-19 outbreak, in a few weeks, overloaded Italian hospitals, and the majority of medical procedures were postponed. During the pandemic, with hospital reorganization, clinical and learning activities performed by residents suffered a forced remodulation. The objective of this study is to investigate how urology training in Italy has been affected during the COVID-19 era. In this multi-academic study, we compared residents' training during the highest outbreak level with their previous activity. Overall 387 (67.1%) of the 577 Italian Urology residents participated in a 72-h anonymous online survey with 36 items sent via email. The main outcomes were clinical/surgical activities, soci…

Variability in the performance of Nuclear Matrix Protein 22 in the detection of bladder cancer. Congress of the American Urological Association, AUA ’06 – Atlanta May 20-25, 2006. (Abstr 984). 317;2006

Studio di phase II: Docetaxel settimanale come seconda linea chemioterapia nel carcinoma prostatico avanzato.

[Endovesical treatment as an alternative to BCG for intermediate or high-risk NMI bladder cancer].

A shortage of BCG is foreseen till the end of 2013. Which will be the management of intermediate and high-risk NMI-BC if BCG will not be available? In patients harboring high-risk NMI tumors, particularly T1G3 and Tis, the first therapeutic choice is radical cystectomy. Device-assisted therapies, although showing promising results, should be considered only for selected patients. In intermediate risk patients, intravesical chemotherapy remains a legitimate option even if BCG is available. Thus, in a period of BCG shortage, intravesical chemotherapy should be offered, preferably preceded by early instillation, according to the EAU guidelines.

Vaginal Metastasis from Renal Cell Carcinoma: The Role of Electron Microscopy

A case of vaginal metastasis from a renal cell carcinoma is reported. This rare localization is often the first clue leading to the diagnosis of an occult renal adenocarcinoma. The role of electron microscopy is emphasized, since the histologic aspect of the lesion is similar to that of a primary vaginal mesonephric adenocarcinoma.

La profilassi antibiotica nell’agobiopsia prostatica

Terapia orale domiciliare per il paziente con il carcinoma prostatico ormonorefrattario.

TERAPIA ORALE DOMICILIARE PER IL PAZIENTE CON CARCINOMA PROSTATICO ORMONOREFRATTARIO V. Altieri, V. Serretta, D. Melloni, R. Allegro, G. Morgia, M. Madonia, M. Ferro, A. Siragusa, G. De Grande, L. Orestano, M. Napoli, E. Membri Fondazione GSTU (Napoli) SCOPO DEL LAVORO: Per preservare la qualità di vita del paziente affetto da carcinoma prostatico ormonorefrattario (HRPC) si rendono necessari regimi terapeutici che possano essere eseguiti a domicilio senza frequenti ricoveri ospedalieri, seppur in regime di dayhospital. I vantaggi in termini di sopravvivenza offerti da schemi chemioterapici a base di taxani, pur presenti, sono ad oggi limitati. Scopo del presente studio di fase II è stato q…

ESTRAMUSTINA FOSFATO VS ASSOCIAZIONE A BASSA DOSE DI ESTRAMUSTINA FOSFATO ED ETOPOSIDE NEL CARCINOMA PROSTATICO ORMONOREFRATTARIO. STUDIO RANDOMIZZATO IN FASE II DEL GRUPPO STUDI TUMORI UROLOGICI (GSTU)

Optimizing intravesical chemotherapy in patients with non muscle invasive bladder carcinoma.

Terapia della patologia mammaria indotta da antiandrogeno puro. Risultati di uno studio randomizzato.

Epidermal Growth Factor Receptor (EGFR) Cell Expression During Adjuvant Treatment After Transurethral Resection for Non-Muscle-Invasive Bladder Cancer: A New Potential Tool to Identify Patients at Higher Risk of Disease Progression

Abstract Background The aim of the study was to investigate the feasibility of Epidermal Growth Factor Receptor (EGFR) measurement in bladder washings of patients affected by non–muscle-invasive bladder cancer (NMIBC) and its prognostic role in identifying risk subgroups and predicting disease recurrence and progression. Patients and Methods Patients with NMIBC treated with transurethral resection of bladder tumor (TURBT) from 2012 to 2015 were enrolled. Samples of bladder washings were collected and stored at −80°C until RNA extraction. The cDNA obtained from RNA was used to perform a gene expression analysis by a real time polymerase chain reaction. Results An adequate cellular pellet was…

La p53 nel tumore vescicale superficiale (Ta-T1, G1-3)

Le Prostatiti batteriche. Inquadramento nosologico e indicazioni diagnostico-terapeutiche.

Potential Effect of Antiplatelet and Anticoagulant Therapy on the Timing of the Diagnosis of Bladder Cancer

Abstract Background The most common presenting symptom of bladder cancer (BCa) is hematuria. The present study was designed to define whether patients taking antiplatelet and/or anticoagulant drugs might experience hematuria at an earlier stage or grade of BCa. Patients and Methods The data from 1532 consecutive patients who presented to the emergency unit of our institute from 2004 to 2012 because of gross hematuria as a single symptom were evaluated. Patients (n = 227) with a further diagnosis of BCa were included in our study. For the purpose of the present study, patients were divided into 2 groups: patients receiving antiplatelet or anticoagulant therapy (AAT) (group 1) and patients no…

LA RIDUZIONE DEL PSA DOPO TERAPIA ANTIBIOTICA NON HA VALORE PREDITTIVO IN SOGGETTI CANDIDATI ALLA AGOBIOPSIA PER SOSPETTO TUMORE PROSTATICO T1C

Attività lavorativa e fattori di rischio ambientale in pazienti affetti da carcinoma vescicale superficiale.

MP26-19 A PROSPECTIVE STUDY ON THE INFLUENCE ON RECURRENCE OF QUITTING CIGARETTE SMOKING AT DIAGNOSIS OF PRIMARY NON MUSCLE INVASIVE BLADDER CANCER

Gemcitabine in intravesical treatment of Ta-T1 transitional cell carcinoma of the bladder: Phase I-II study on marker lesions

Abstract Objectives To study the ablative activity of intravesical gemcitabine against superficial transitional cell carcinoma of the bladder at different doses and concentrations. Methods A total of 27 patients were treated with intravesical gemcitabine after transurethral resection during which one to three papillary marker lesions were left unresected. Starting 14 days after transurethral resection, six instillations of gemcitabine were given at weekly intervals. Gemcitabine, diluted in 50 mL of saline solution and maintained for 2 hours, was given at the dose of 500 mg, 1000 mg, and 2000 mg in groups of 9 patients each. A complete response (CR) was defined as negative cytology, cystosco…

Open prostatectomy for benign prostatic enlargement in southern Europe in the late 1990s: A contemporary series of 1800 interventions

Abstract Objectives Contemporary series of open prostatectomies from Western countries are rare. Frequently, the analysis of the outcome of open prostatectomy refers to old experiences or to series from developing countries. Any comparison with transurethral resection of the prostate can be invalidated by complications of open surgery because of the lack of an adequate healthcare system and technology. Methods The Sicilian-Calabrian Society of Urology performed a retrospective study to assess the surgical management of benign prostatic hyperplasia in Sicily and Calabria in 1997 and 1998. A three-page questionnaire was sent to the 36 urologic units of these two Italian regions with more than…

Short and mid-term Functional Outcomes after High-intensity Ultrasound (HiFu) in the treatment of patients with localized advanced prostate cancer

PROSTATA (PROSTATITI, IPERTROFIA PROSTATICA, CANCRO DELLA PROSTATA)

Epidemiologia della malattia in Italia. Cosa ècambiato? Territorio, le professioni e lo stile di vita. E' giunto il tempo dello screening?

Epidemiology of disease conditions in Italy. Has anything changed? Environment, professional exposure, and lifestyle. Is time for screening? Risk factors analysis in bladder cancer should consider not only the clinical and pathological features of the tumor but also environmental and lifestyle factors. They may play, in fact, a relevant role not only in the pathogenesis but also in the biological behavior of the tumor. The association between cigarette smoking and bladder cancer has been consistently confirmed in several case-control and cohort studies. The risk of bladder cancer seems to increase with duration and intensity of smoking. Another environmental risk factor, although not defini…

Rari tumori mesenchimanli. Descrizione di 2 casi clinici.

ESTRAMUSTINE PHOSPATE VERSUS INTERMITTENT LOW DOSE ORAL COMBINATION OF ESTRAMUSTINE PHOSPATE AND ETOPOSIDE IN HORMONE REFRACTORY PROSTATE CARCINOMA. A PHASE II STUDY OF GSTU FOUND.

A prospective observational study on oral administration of Ellagic Acid and Annona Muricata in patients affected by non-muscle invasive bladder cancer not undergoing maintenance after 6-week intravesical prophylaxis

Introduction: BCG and MMC shortage and Covid-19 pandemic, more recently, limit accessibility to maintenance regimen in intravesical prophylaxis against recurrence of non-muscle invasive bladder cancer (NMIBC). Ellagic acid (EA) and Annona muricata (AM) exert antitumor activity against different human tumours. An observational prospective study on the prophylactic effect of oral administration of EA+AM in patients avoiding maintenance regimen is presented. Materials and methods: Patients affected by NMIBC and not undergoing maintenance after a 6-week course of intravesical prophylaxis with MMC or BCG were entered. Tis and very high-risk tumours were excluded. After informed consent, the pati…

POSITIVITA’ DELL’NMP22 E NEGATIVITA’ CISTOSCOPICA E CITOLOGICA. QUALE SIGNIFICATO ATTRIBUIRE?

RISK FACTORS FOR RESIDUAL DISEASE AT RE-TUR IN T1G3 BLADDER CANCER

Cytokines gene expression in the tunica albuginea of patients with Peyronie’s disease. Pilot study with a control group

INTRODUCTION & OBJECTIVES: Cytokines may be involved in the pathogenesis of the Peyronie's disease (PD). Cytokines levels in tunica albuginea (TA) specimens were measured by Real Time PCR in PD patients and in control group. MATERIAL & METHODS: Between January 2009 and December 2010 20 PD patients affected by PD and 8 patients affected by congenital recurvatum penis (control group) undergoing surgery were entered in the study. Routine histological examination and measurement by Real Time PCR of the expression of the encoding genes for IL-2, IL-4, IL-6, IL-10, IL-13, TGF-β1, TNF-α, IFN-γ and Metalloproteinase (MMP-2) were performed. For the normalization of data, GAPDH (glucerldehyde-3 fosfa…

Fumo, risorsa idrica ed altri fattori di rischio nel carcinoma vescicale superficiale

The activity of intravesical hyaluronic acid and chondroitin sulfate administration on urothelial gene expression. Preliminary results on the epidermal growth factor receptor and fibronectin gene expression evaluated in bladder washings of patients affected by non muscle-invasive bladder cancer

Drinking water source and cigarette smoking in transitional cell carcinoma of the bladder.

OBJECTIVE: Water source and cigarette smoking are related to clinical characteristics and pathology of superficial transitional cell carcinoma of the bladder. METHODS: Tumor number, dimension, G-grade, T-stage, recurrences, cigarette smoking and water supply were recorded in patients harboring Ta-T1 G1-3 transitional cell carcinoma of the bladder. RESULTS: Of 577 patients, 61% had multiple and 36% recurrent tumors. Two hundred and forty-one patients (42%) were current smokers and 188 (33%) were former smokers. Bottled water was the only drinkable source for 249 (45%) patients, municipal water supply for 177 (32%), artesian wells for 38 (7%), spring water for 7 (1%) and mixed source for 89 (…

Survival risk factors in T1G3 non-muscle-invasive (NMI) bladder cancer consevatively treated. Long term results.

Introduction: The most relevant risk factor in T1G3 NMI transitional cell carcinoma of the bladder (TCCB) is the presence of Tis. The long term results of conservative management still are a matter of controversy. The role of BCG in preventing progression and death in this category of NMI TCCB is not definitely proved. The published experiences of conservative treatment of high risk TCCB often include unselected patients, small numbers and short follow-up. Immediate radical cystectomy is advocated by many urologists. Objectives: The aim of the study is to identify the survival risk factors in 236 selected patients conservatively treated. Methods: Between January 1976 and December 2005, 236 …

SMOKING STATUS, RECURRENCE RISK AND INTRAVESICAL CHEMOTHERAPY IN NONMUSCLE- INVASIVE BLADDER CANCER

Background and Aim: The influence of smoking status on the diagnosis of carcinoma of the bladder, on recurrence risk Abstracts of the 21st Annual Meeting of the Italian Society of Uro-Oncology (SIUrO), 22-24 June, 2011, Naples, Italy and response to intravesical treatment has been scarcely studied. Available studies suggest a reduction in recurrence risk with cessation of smoking, however, most studies lack sufficient statistical power. The aim of the present analysis was to study the recurrence risk and the response to intravesical chemotherapy in terms of recurrence-free rate (RFR) and recurrence-free survival (RFS) in relation to smoking status at diagnosis in patients affected by interm…

Fumo di sigaretta e risorsa idrica in pazienti affetti da carcinoma vescicale superficiale. XV Congresso Nazionale SIUro, Giardini Naxos 3-6 novembre 2005. 1.

Factores de riesgo de enfermedad residual en la re-RTU en una gran cohorte de pacientes con enfermedad T1G3

Resumen Introduccion y objetivos Los objetivos de la reseccion transuretral (RTU) del tumor vesical son la reseccion completa de las lesiones y la realizacion de un diagnostico correcto con el objetivo de estadificar adecuadamente al paciente. Es bien sabido que la presencia de musculo detrusor en el especimen es un requisito previo para minimizar el riesgo de infraestadificacion. La persistencia de enfermedad tras la reseccion de los tumores vesicales no es infrecuente, y es la razon por la que las guias europeas recomiendan una re-reseccion transuretral (re-RTU) para todos los tumores T1. Recientemente se ha publicado que, en los casos con inclusion de musculo en el especimen, la re-RTU n…

Ipertermia e chemioterapia nel tumore vescicale superficiale a medio-alto rischio:esperienza preliminare sulla tollerabilità.

Microwave-Induced Hyperthermia and Cytostatic Agent for Superficial Bladder Cancer

The efficacy and local toxicity of the intravesical combination of microwave-induced hyperthermia with a cytostatic agent in patients affected by superficial bladder cancer is presented. Between 1994 and 2002, two studies were performed on ablative and adjuvant intravesical thermo-chemotherapy. The ablative study demonstrated complete tumor eradication in 88% of patients who should have undergone cystectomy due to diffuse multiple papillary tumors non-responsive TUR and intravescical adjuvant therapy. In a randomized study, comparing adjuvant thermo-chemotherapy vs. standard chemotherapy with mitomycin C, recurrence-free survival analysis at 24 months revealed a significant difference in f…

low dose oral chemotherapy for hormone refractory prostate carcnoma.Estramustine phosphate versus estramustine phosphate and etoposide. A randomised phase II study of GSTU Found.

Fattori di rischio ambientali nella storia naturale del carcinoma vescicale superficiale.

Role of antimicrobial tratment in patients with elevated PSA and normal digital rectal examination.

Randomized Phase II trial assessing estramustine and vinblastine combination chemotherapy vs estramustine alone in patients with progressive hormone-escaped metastatic prostate cancer

Abstract Based on the results of combined data from three North American Phase II studies, a randomised Phase II study in the same patient population was performed, using combination chemotherapy with estramustine phosphate (EMP) and vinblastine (VBL) in hormone refractory prostate cancer patients. In all, 92 patients were randomised into a Phase II study of oral EMP (10 mg kg day continuously) or oral EMP in combination with intravenous VBL (4 mg m(2) week for 6 weeks, followed by 2 weeks rest). The end points were toxicity and PSA response in both groups, with the option to continue the trial as a Phase III study with time to progression and survival as end points, if sufficient responses…

Salvage Therapy With Oral Metronomic Cyclophosphamide and Methotrexate for Castration refractory Metastatic Adenocarcinoma of the Prostate Resistant to Docetaxel

Objective To investigate the activity and toxicity of metronomic chemotherapy with low-dose oral cyclophosphamide (CTX) and methotrexate (MTX) in patients with metastatic CRPC that progresses after docetaxel. Patients with castration-resistant prostate cancer (CRPC) that progresses after docetaxel may benefit from receiving further chemotherapy. Methods Patients were treated with CTX 50 mg/d p.o. plus MTX 2.4 mg p.o. twice per week without rest periods. All patients received simultaneous luteinizing hormone-releasing hormone analogue. Prostate-specific antigen (PSA) response was defined as a 50% reduction on 2 evaluations at least 4 weeks apart. Objective response was measured according to …

Are referral centers for non-muscle invasive bladder cancer compliant to EAU guidelines? A report from the vesical antiblastic therapy Italian study

&lt;i&gt;Introduction:&lt;/i&gt; Adherence to international guidelines is viewed as a prerequisite for optimal medical care delivery. Previously reported surveys for non-muscle-invasive bladder cancer (NMIBC) employed mailed questionnaires to urologists or patients resulting in conflicting degrees of agreement with existing guidelines. In the current study, contemporary information on the management of NMIBC was generated from a sample of Italian centers. &lt;i&gt;Patients and Methods:&lt;/i&gt; Eight Italian referral centers for the treatment of NMIBC were asked to collect information relative to all consecutive patients with a histology-proven NMIBC undergoing a transurethral resection fr…

Il carcinoma prostatico in Calabria e Sicilia.

Sexual dysfunction in dialytic patients. A prospective cross-sectional observational study in two hemodialysis centers

Objectives: Incidence and prevalence of patients in dialytic therapy increased considerably in recent years. The onset of new issues, once overshadowed, linked to a lower quality of life like sexual dysfunction became increasingly common. The first study in this area, dating back to the 1970s, shows the high prevalence of sexual dysfunction among patients in dialytic therapy of both sexes. Later studies proved an association of sexual dysfunction with psyche disorders, anxiety, depression and lack of self-confidence. The aim of this study is to describe the incidence of male and female sexual main dysfunctions, the latter not least in literature, in patients in hemodialytic therapy. With th…

Predictors of oncological outcomes in T1G3 patients treated with BCG who undergo radical cystectomy

PURPOSE: To evaluate the oncological impact of postponing radical cystectomy (RC) to allow further conservative therapies prior to progression in a large multicentre retrospective cohort of T1-HG/G3 patients initially treated with BCG. METHODS: According to the time of RC, the population was divided into 3 groups: patients who did not progress to muscle-invasive disease, patients who progressed before radical cystectomy and patients who experienced progression at the time of radical cystectomy. Clinical and pathological outcomes were compared across the three groups. RESULTS: Of 2451 patients, 509 (20.8%) underwent RC. Patients with tumors > 3 cm or with CIS had earlier cystectomies (HR = 1…

Risk factors for residual disease at re-TUR in a large cohort of T1G3 patients

Item does not contain fulltext Introduction and objectives: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. It is well known that the presence of detrusor muscle in the specimen is a prerequisite to minimize the risk of under staging. Persistent disease after resection of bladder tumors is not uncommon and is the reason why the European Guidelines recommended a re-TUR for all T1 tumors. It was recently published that when there is muscle in the specimen, re-TUR does not influence progression or cancer specific survival. We present here the patient and tumor factors th…

La gestione, e la prevenzione, delle complicanze della terapia endovescicale

Cytokine gene expression in the tunica albuginea of patients with Peyronie's disease. Pilot study with a control group.

Introduction and objective Cytokines may be involved in the pathogenesis of Peyronie's disease (PD). In this case, biological drugs, acting on specific cytokines, could be adopted in the pharmacological treatment of the disease. Materials and Methods Twenty PD patients and 8 patients affected by congenital recurvatum penis (control group) who underwent corporoplasty were enrolled in the study Histological examination and measurement by Real Time PCR of the expression of the encoding genes for IL-2, IL-4, IL-6, IL-10, IL-13, TGF-β, TNF-α and IFN-γ were performed on the removed tunica albuginea (TA). For the normalization of data GAPDH (glucerldehyde-3fosfatehydrogenase) and GUSB (β-glucuroni…

Chemio-termoterapia endovescicale e prospettive future.

Variability in the performance of nuclear matrix protein 22 for the detection of bladder cancer.

PURPOSE: We assessed variability in the diagnostic performance of NMP22 for detecting recurrence and progression in patients with Ta, T1, and/or CIS transitional cell carcinoma of the bladder in a large international cohort. MATERIALS AND METHODS: NMP22 voided urine levels were measured in 2,871 patients who underwent office cystoscopy for monitoring previous stage Ta, T1 and/or CIS transitional cell carcinoma at 12 participating institutions. RESULTS: Patient characteristics varied considerably among institutions. Overall 1,045 patients (36.4%) had recurrent transitional cell carcinoma (range across institutions 13.6% to 54.3%). Median NMP22 was 5.5 U/ml (range across institutions 2.5 to 1…

Risultati di uno studio pilota di fase I-II con gemcitabina endovescicale nel tumore vescicale superficiale (TA-T1)

Segmental resection of distal ureter with termino-terminal ureteric anastomosis vs bladder cuff removal and ureteric re-implantation for upper tract urothelial carcinoma: results of a multicentre study

OBJECTIVES: To compare overall (OS), cancer-specific (CSS), recurrence free survival (RFS) and post-operative renal function among patients affected by upper tract urothelial carcinoma (UTUC) of the distal (lower lumbar and pelvic) ureter, electively treated with segmental resection and termino-terminal anastomosis (TT) vs bladder cuff removal and ureteral re-implantation (RR). PATIENTS AND METHODS: A multicentre retrospective study, including 84 patients diagnosed with UTUC of the distal ureter and treated with TT or RR, is presented. The primary endpoint was to compare TT and RR in terms of OS, CSS and RFS. As a secondary outcome we compared the post-operative creatinine values as an inde…

Out-patient low-dose oral chemotherapy in hormone refractory prostate carcinoma (HRPC) patients unfit for hospital admittance.

Objectives: Well tolerated out-patient regimens for HRPC chemotherapy in elderly patients with geographical difficulties and/or unwilling hospital admission are needed. The aim of the present study was to investigate the safety and efficacy of a low-dose oral combination of estramustine phosphate (EMP) and etoposide (VP16). Patients: Fifty-six HRPC patients, median age 75 years, were randomized between daily EMP (10mg/kg) – arm A, and low-dose EMP (3mg/kg) plus VP16 (25mg/mq) 2 weeks monthly – arm B. Randomization ratio was 2:3. Median PSA was 41.1 ng/ml. Baseline characteristics between the 2 groups were similar. LHRH therapy was maintained. Antiandrogen was stopped one month before entry.…

La chemioterapia endocavitaria (relazione su invito). Il Carcinoma transizionale della vescica.

EPIRUBICINA DA SOLA VS EPIRUBICINA + MITOMICINA NELLA PROFILASSI ENDOCAVITARIA DI NEOPLASIE UROTELIALI SUPERFICIALI DELLA VESCICA. STUDIO PROSPETTICO MULTICENTRICO RANDOMIZZATO

TUR and Adjuvant Intravesical Chemotherapy in T1G3 Bladder Tumors: Recurrence, Progression and Survival in 137 Selected Patients Followed Up to 20 Years

Abstract OBJECTIVES: To evaluate a highly selected population of patients affected by T1G3 bladder transitional cell carcinoma (TCCB) treated by transurethral resection (TUR) and adjuvant intravesical chemotherapy. MATERIALS AND METHODS: Between January 1976 and April 1999, 137 patients with T1G3 TCCB were treated by TUR plus intravesical chemotherapy. Particularly, a sequential combination of mitomycin C (MMC) and epirubicin (EPI) was adopted in 91 patients (66.4%). The main exclusion criteria were concomitant or previous Tis, previous T1G3 TCCB, tumor size greater than 3 centimeters and number of tumors more than 3. TUR was repeated if a superficial tumor recurred. Patients went off study…

Significato clinico della positività della NMP22 in pazienti in follow-up per carcinoma vescicale superficiale. Risultati a lungo termine

Tamoxifene nella mastopatia da bicalutamide. Risultati preliminari di uno studio randomizzato: profilassi versus terapia alla comparsa.

A randomized phase II study of estramustine phosphate versus estramustine phosphate plus etoposide in hormone refractory prostate cancer (HRPC)

20632 Background: Docetaxel-based regimens represent the treatment of choice of HRPC. However, in some patients toxicity may be a concern and the quality of life may be compromised. The aim of this phase II randomized study is to investigate the efficacy and safety of low-dose chemotherapy regimen adopting a combination of EMP and VP16 in patients affected by HRPC. Methods: 54 HRPC patients were randomized between: arm A, daily oral standard dose EMP (10mg/kg) and arm B, low-dose EMP (3mg/kg) plus VP16 (25mg/mq) for 2 weeks followed by 2-weeks’rest. Systemic toxicity and hematologic exams were monitored every 2 weeks. Performance status, pain and analgesic use were evaluated according to WH…

Impact of stage migration on bladder cancer: A slow but steady improvement in the long term survival rates after radical cystectomy in the last 25 years

INTRODUCTION &amp; OBJECTIVES: Bladder cancer (BCa) is a heterogeneous disease with up to 25% of incidental diagnoses reported to be found muscle invasive at first episode. Numerous markers and an increased awareness have been recorded in the recent years. We sought to evaluate if those considerat ions may determine a change in BCa clinical presentation at radical cystectomy (RC) over years in a single high volume tert iary referral center. MATERIAL &amp; METHODS: The study relied on 2,003 consecutive BCa pat ients treated with RC and extended pelvic lymphadenectomy (PLND) at a single inst itution between January 1990 and December 2014. Pat ients were st ratified into tertiles according to …

Clinical and biochemical markers of visceral adipose tissue activity: Body mass index, visceral adiposity index, leptin, adiponectin, and matrix metalloproteinase-3. Correlation with Gleason patterns 4 and 5 at prostate biopsy

Context: The correlation between aggressive prostate cancer and obesity mainly based on body mass index (BMI) and pathology after surgery remains controversial. Aims: The aim of the study was to correlate BMI, visceral adiposity index (VAI), and the plasmatic levels of leptin, adiponectin, and matrix metalloproteinase-3 (MMP-3), and biomarkers of adipose tissue function, with the detection of Gleason patterns 4 and 5 at biopsy. Subjects and Methods: Consecutive patients with prostate cancer at 12-core transrectal biopsy were enrolled. BMI, waist circumference (WC), blood samples to evaluate the plasmatic levels of triglycerides (TG) and high-density lipoproteins (HDL), adiponectin, leptin, …

The Impact of Perioperative Blood Transfusion on Survival of Bladder Cancer Patients Submitted to Radical Cystectomy: Role of Anemia Status.

Background The prognostic role of perioperative blood transfusion (PBT) in patients who underwent radical cystectomy (RC) for bladder cancer (BCa), although supported by clinical evidence, still remains to be assessed definitively. Objective To investigate the impact of PBT on RC patients for overall survival and after stratifying according to preoperative anemia status and to define whether the oncologic impact may be assumed to be a primary effect of PBT or attributed to the reduced preoperative hemoglobin (Hb) level. Design, setting, and participants A total of 1490 consecutive patients with nonmetastatic BCa who underwent RC and pelvic lymph node dissection between January 1990 and Augu…

Peyronie’s disease: Cytokines genes expression in tunica albuginea

THE ROLE OF PERI-OPERATIVE BLOOD TRANSFUSION ON CANCER SPECIFIC AND OVERALL MORTALITY AFTER RADICAL CYSTECTOMY FOR BLADDER CANCER

Only few studies investigated the impact of the peri-operative blood transfusion (PBT) rate on both cancerspecific (CSM) and overall mortality (OM) after radical cystectomy (RC) for bladder cancer (Bca). To date, no study has taken into account the possible prognostic role of the pre-operative hemoglobin level (Hb). The aim of this study was to evaluate the impact of both pre-operative Hb level and PBT rate on CSS and OS of patients who underwent RC. Materiali e metodi The study cohort included 1575 patients treated with RC for BCa between 1990 and 2012 at a single tertiary referral center. Complete clinical, pathological and follow up-data was available for all the patients. Kaplan- Meier …

PSA reduction (after antibiotics) permits to avoid or postpone prostate biopsy in selected patients

Microscopic foci of prostatitis may induce prostate-specific antigen (PSA) increase. PSA reduction after antibiotics might identify those patients in whom biopsy can be avoided. Ninety-nine patients received ciprofloxacin for 3 weeks, of whom 59 showed PSA reduction. Histology detected small foci of prostatitis in 65% of cases. Carcinoma was found in 40 and 20.3% of patients with unchanged or decreased PSA, respectively (P=0.03). No cancer was detected if PSA decreased below 4 ng/ml or more than 70%. Biopsy can be postponed, with a low risk of missing a cancer, if PSA decreases more than 70% or below 4 ng/ml.

Ruolo prognostico della p53 nel tumore vescicale superficiale. Correlazione con recidiva e progressione –

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TERAPIE CONSERVATIVA DELL'UROTELIOMA VESCICALE T1G3. RISULTATI SU 235 PAZIENTI

Correlation between Chronic Prostatitis Syndrome and Pelvic Venous Disease

Objectives: In this study we evaluated the association between chronic prostatitis syndrome (CPS), varicocele and hemorrhoids as manifestations of a pelvic venous disease.<b&g

Studio retrospettico esteso ad oltre 20 anni su BCG o chemioterapia endovescicale in pazienti selezionati affetti da urotelioma vescicale T1G3. Recidiva, progressione e sopravvivenza.

The fate of patients with locally advanced bladder cancer treated conservatively with neoadjuvant chemotherapy, extensive transurethral resection and radiotherapy: 10-year experience

Purpose: We assess the results of bladder preservation for infiltrating bladder cancer. The potential for neoadjuvant chemotherapy followed by extensive transurethral resection and radiotherapy was evaluated in 40 patients with T2-T4a G2-G3 bladder carcinoma. Materials and Methods: From 1983 to 1995, 40 patients with bladder cancer underwent bladder sparing treatment, consisting of neoadjuvant chemotherapy, extensive transurethral resection and radiotherapy. Most patients had T3G3 cancer. A deep transurethral resection biopsy was performed before and after chemotherapy, and an extensive transurethral resection was repeated at the end of radiotherapy. Of the patients 30 received cisplatin an…

INTRAVESICAL GEMCITABINE IN SUPERFICIAL BLADDER TUMOURS.RESULTS OF A PHASE I-II STUDY

Is the efficacy of intravescical chemotherapy influenced by cigarette smoking? Data obtained in intermediate risk non muscle invasive bladder carcinoma.

Aim of the study To study recurrence-free rate (RFR) and recurrence-free survival (RFS) according to the smoking status in patients affected by non-muscle invasive carcinoma of the bladder (NMI-BC) treated by intravesical chemotherapy. Materials and methods Smoking status was recorded at study entry. Intravesical epirubicin was administered within 6 hours from TUR at the dose of 80 mg diluted in 50 ml of saline solution. Further adjuvant treatment in low-risk and high-risk patients was given according to physicians’ choice. The remaining patients, at intermediate risk for recurrence, were randomized between two different schemes of intravesical chemotherapy: 5 more weekly instillations (tot…

Cigarette Smoking Status at Diagnosis and Recurrence in Intermediate-risk Nonemuscle-invasive Bladder Carcinoma

Objective To study the effect of smoking status at diagnosis on recurrence in intermediate-risk non–muscle-invasive bladder carcinoma treated by transurethral resection (TUR) of the bladder and early intravesical chemotherapy. Methods Tumor characteristics and smoking status were recorded in 395 patients entered in a randomized multicenter trial comparing 2 different schedules of early intravesical chemotherapy. All patients received intravesical epirubicin (80 mg/50 mL) within 6 hours after TUR, followed by 5 more weekly instillations with (arm B) or without (arm A) monthly instillations for 1 year. Smoking habit was investigated at diagnosis through a structured questionnaire. Multivariat…

Combined renal and pyelic fusion with crossed ectopia of single ureter. Urology 28:339-41;1986

A case of a forty-five-year-old woman with fused kidneys and intercommunicating pelves drained by a single ureter crossing the midline is reported. A review of the literature is presented.

Results of a Phase I-II Pilot Study with Intravescical Gemcitabine in Superficial Bladder Cancer (Ta-T1)

To study the ablative activity of intravescical gemcitabine against superficial transitional cell carcinoma of the bladder at different doses and concentrations. Methods Twenty-seven patients were treated with intravescical gemcitabine after transurethral resection, during which one to three papillary marker lesions were left unresected. Starting 14 days after transurethral resection, six gemcitabine instillations were given at weekly intervals. Gemcitabine, diluted in 50 mL of saline solution and maintained for 2 hr, was given at a dose of 500, 1000 and 2000 mg in groups of nine patients each. A complete response (CR) was defined as negative cutologycystoscopy and biopsy findings. Results…

Pilot Study on Predictive Value of Plasmatic Levels of 9 Angiogenetic Biomarkers in Selection of Patients Candidate to Prostate Biopsy

To reduce the number of negative prostate biopsies in patients with elevated PSA serum levels represents a major challenge in urological oncology. Angiogenetic factors might be involved in initial stages of prostate cancer and might represent useful tools in patients’ selection for prostate biopsy. The plasmatic levels of Angiopoietin-2, Follistatin, G-CSF, HGF, IL-8, Leptin, PDGF-BB, PECAM-1 and VEGF were measured by BioPlex immunoassay in patients undergoing prostate biopsy for palpable prostate nodule and/or elevated PSA levels (≥4 ng/mL). They were related with biopsy results. ROC curve analysis was exploited to test the diagnostic accuracy of each biomarker by AUC calculation. A poten…

Whatsapp messenger as a tool for the multidisciplinary management in everyday clinical practice

Introduction &amp; Objectives Communication between doctors is traditionally conducted by written clinical charts. Mobile health is becoming an integral part of modern healthcare system, improving accessibility and quality of medical care. Recent papers suggest that an increasing number of doctors are using in their practice mobile tools to communicate clinical informations (1,2). The aim of our study was to verify the adoption of WhatsApp Messenger in everyday clinical practice to obtain a real-time multidisciplinary collaboration among medical centers located in different areas of the city. Material &amp; Methods In January 2016 a WhatsApp Messenger group was created among 25 specialists:…

Significato clinico della positività della NMP22 in pazienti in follow-up per carcinoma vescicale superficiale. Risultati a lungo termine

BIOMARKERS OF UROTHELIAL DAMAGE IN PATIENTS TREATED BY ADJUVANT INTRAVESICAL THERAPY

Introduction/Aim: Chemotherapy or BCG given intravesically to prevent recurrence after transurethral resection (TUR) of non-muscle invasive bladder cancer (NMI-BC) cause frequent, sometime severe, local toxicity. As a consequence, many patients do not complete the planned treatment (1). A major challenge for the urologists is to identify an early biomarker of urothelial damage to recognize and prevent local toxicity improving patient’s compliance. The purpose of our research was to investigate the relation between urothelial injury by intravesical treatment and the expression of potential biomarkers in urine and/or in barbotage solution. The urinary HB-EGF expression in interstitial cystiti…

T1HG Bladder Tumours: So Many Papers, Do We Need Them? Yes, We Do!

“How many roads a man must walk on….” and how many papers we must read and write… to put down the final word on the appropriate management of high risk NMI-BC. Although it is more than 20 years that we take notice of promises on biological markers predictive of the behaviour of NMI-BC, till today we can only base our decisions on clinical and pathological data. Consequently, we need exchange of experiences and reports on the outcome of these patients. The aim of the treatment of T1 bladder tumours is to minimize mortality while assuring reduced morbidity and good quality of life. A conservative approach is, obviously, not applicable to all T1HG tumours. We need to identify unequivocal selec…

Long-term outcome of antiandrogen monotherapy in advanced prostate carcinoma. Twelve-year’s results of a phase II study.

OBJECTIVE: To present the long-term outcome of patients with locally advanced or metastatic prostate carcinoma treated by first-line antiandrogen monotherapy. PATIENTS AND METHODS: From 1983 to 1990, 41 patients with advanced prostate carcinoma were treated with flutamide monotherapy until progression or the appearance of toxicity. Twenty-five patients (61%) had T3-T4N0M0 and 16 (39%) T2-4N0-3M1 prostate carcinoma. Consensus criteria were adopted to evaluate the response. Plasma testosterone and sexual function were recorded for the first 3 years. RESULTS: Flutamide was administered for up to 147 months; seven patients (17%) interrupted the treatment because of toxicity. There was an object…

Sospensione del fumo alla prima diagnosi di carcinoma non muscolo invasivo della vescica (NMIBC) e rischio di recidiva

Re: Urinary pH is Highly Associated With Tumor Recurrence During Intravesical Mitomycin C Therapy for Nonmuscle Invasive Bladder Tumor

The impact of re-transurethral resection on clinical outcomes in a large multicentre cohort of patients with T1 high-grade/Grade 3 bladder cancer treated with bacille Calmette-Guerin

Objectives To determine if a re-transurethral resection (TUR), in the presence or absence of muscle at the first TUR in patients with T1-high grade (HG)/Grade 3 (G3) bladder cancer, makes a difference in recurrence, progression, cancer specific (CSS) and overall survival (OS). Patients and methods In a large retrospective multicentre cohort of 2451 patients with T1-HG/G3 initially treated with bacille Calmette–Gu erin, 935 (38%) had a re-TUR. According to the presence or absence of muscle in the specimen of the primary TUR, patients were divided in four groups: group 1 (no muscle, no re-TUR), group 2 (no muscle, re-TUR), group 3 (muscle, no re-TUR) and group 4 (muscle, re-TUR). Clinical out…

Trattamento endovescicale alternativo al BCG nel carcinoma vescicale NMI a rischio intermedio o elevato

Endovesical treatment as an alternative to BCG for intermediate or high-risk NMI bladder cancer A shortage of BCG is foreseen till the end of 2013. Which will be the management of intermediate and high-risk NMI-BC if BCG will not be available? In patients harboring high-risk NMI tumors, particularly T1G3 and Tis, the first therapeutic choice is radical cystectomy. Device-assisted therapies, although showing promising results, should be considered only for selected patients. In intermediate risk patients, intravesical chemotherapy remains a legitimate option even if BCG is available. Thus, in a period of BCG shortage, intravesical chemotherapy should be offered, preferably preceded by early …

PLEOMORPHIC HYALINIZING ANGIOECTATIC TUMOR (PHAT) OF RENAL PARENCHYMA. FIRST CASE REPORTED IN LITERATURE

Carcinoma Uroteliale in Cisti Pielogena

Urothelial carcinoma in a pyelocaliceal cyst Renal complex cysts are lesions whose nature can be either benign or malignant. Depending on the presence of septa, solid components, enhancement or calcifications, they are distinguished according to the Bosniak classi- fication based on CT findings, as well as MRI and ETG. We report a rare case of urothelial carcinoma, originating over a pyelocalyceal cyst in a 50-year-old man, and classified as Bosniak IIF by CT and MRI investigations.

THE IMPACT OF DIFFERENT BCG STRAINS ON OUTCOME IN A LARGE COHORT OF T1G3 PATIENTS TREATED WITH BCG

Studio clinico randomizzato, cross over, in aperto con Tadalafil per valutare uno schema ottimale di trattamento in pazienti con DE: nostra esperienza

Antibiotic Prophylaxis in Prostate Biopsy

Introduction Prostate biopsy is nowadays one of the most frequent diagnostic procedures in urology. The incidence of bacteraemia, bacteriuria and infective complications is higher after the transrectal procedure than after the transperineal one. A survey demonstrated that 98% of the urologists in USA use antibiotics to prevent infective complications. The transrectal prostate biopsy is the only diagnostic intervention procedure in urology for which an antibiotic prophylaxis is recommended, also for low-risk patients, by the guidelines of the European Association of Urology. If the perineal route is adopted, the antibiotic prophylaxis is recommended only in high-risk patients. Materials and …

Genitourinary Symptoms—Patient Help-Seeking and General Practitioner Management: An Outpatient Based Survey at a Tertiary Hospital in Southern Italy

Abstract Introduction General knowledge of most common genitourinary diseases is often lacking. In this survey we evaluated the attention given by patients and general practitioners to genitourinary symptoms, and particularly to hematuria and potential early signs of genitourinary cancer. Methods A structured self-administered questionnaire was administered to outpatients before the urological consultation. The questionnaire consisted of 4 multiple choice questions to record the level of patient awareness of urological symptoms, the importance given to gross hematuria, the interval between the onset and the visit, the regularity of physical examination and the first-level investigations ind…

COMPLIANCE WITH ONE YEAR MAINTENANCE INTRAVESICAL BCG IN PATIENTS AFFECTED BY T1G3 BLADDER CANCER

Introduction: BCG maintenance for at least one year is the best regimen for prevention of recurrence and progression in high risk non muscle invasive bladder cancer (NMIBC), undergoing conservative approach. Noteworthy, a relevant number of patients do not complete the planned treatment interruption. Study aim was to analyze retrospectively the reasons of treatment. Patients and Methods: Consecutive patients affected by T1G3 BC, undergoing BCG maintenance for one year, according to the SWOG schedule (3 weekly instillations at 3, 6, 12 months) were included in this study. Connaught BCG (81 mg/50 ml) was given starting 1430 days after TUR. If toxicity occurred, treatment was postponed up to t…

A RANDOMISED STUDY EVALUATING MAINTENANCE SCHEDULE IN EARLY ADJUVANT CHEMOTHERAPY FOR INTERMEDIATE RISK NON-MUSCLE-INVASIVE BLADDER CANCER

ABSTRACT Introduction and Objective: Adjuvant intravesical chemotherapy or BCG immunotherapy after transurethral resection (TUR) is a standard treatment for non–muscle-invasive transitional cell cancer of the bladder (NMI TCCB) at intermediate risk. Although the clinical value of early intravesical adjuvant chemotherapy is well established, the optimal schedule regimen and the role of maintenance is still debated. Methods: Between May 2002 and August 2003, 577 patients, undergoing TUR for NMI TCCB, were recruited. All patients underwent TUR and early (within 6 hours) intravesical chemotherapy with epirubicin at the dose of 80 mg diluted in 60 ml of saline solution. When histology was availa…

Is Kelami's Method Still Useful in the Smartphone Era? The Virtual 3-Dimensional Reconstruction of Penile Curvature in Patients With Peyronie's Disease: A Pilot Study

Abstract Background Peyronie's disease is an idiopathic fibrotic disease affecting the penile tunica albuginea. Among other resulting deformities, the more common penile curvature should be assessed preferentially with in-office goniometric estimation after pharmacologically induced erection, although clearly invasive and uncomfortable. Aim In the present pilot study, we investigated the usefulness for the patient and the surgeon of a 3-dimensional (3D) reconstruction of the penile curvature obtained through photogrammetry software in clinical evaluation and surgical planning. Methods Enrolled patients received alprostadil 10 μg by intracavernous injection. Then, the medical personnel took …

Diagnosi precoce del carcinoma prostatico in Sicilia e Calabria. Dati preliminari di uno studio osservazionale del GSTU e della SSCU

Recurrence, progression and cancer-specific mortality according to stage at re-TUR in T1G3 bladder cancer patients treated with BCG: not as bad as previously thought

PURPOSE: The goals of transurethral resection of a bladder tumor (TUR) are to completely resect the lesions and to make a correct diagnosis to adequately stage and treat the patient. Persistent disease after TUR is not uncommon and is why re-TUR is recommended in T1G3 patients. When there is T1 tumor in the re-TUR specimen, very high risks of progression (82%) have been reported. We analyze the risks of recurrence, progression to muscle-invasive disease and cancer-specific mortality (CSM) according to tumor stage at re-TUR in T1G3 patients treated with BCG. METHODS: In our retrospective cohort of 2451 T1G3 patients, 934 patients (38.1%) underwent re-TUR. 667 patients had residual disease (7…

NEPA as antiemetic prophylaxis after failure of 5HT3-RA plus dexamethasone in patients receiving carboplatin and gemcitabine chemotherapy: A monocentric real-life experience

Introduction Chemotherapy-induced nausea and vomiting (CINV) may affect adherence to planned chemotherapy treatments and compromise patients’ quality of life during the therapy. NEPA is an oral fixed combination of netupitant, a highly-selective NK1-RA and palonosetron, a 5HT3-RA, approved for the prevention of acute and delayed CINV. The aim of this study was to evaluate the efficacy and safety of NEPA with dexamethasone for CINV prophylaxis in the challenging setting of carboplatin and gemcitabine combination chemotherapy, after failure of prophylaxis with 5HT3 receptor antagonist. Methods Eligible patients were undergoing carboplatin and gemcitabine combination chemotherapy for metastati…

Systemic Inflammatory Markers and Oncologic Outcomes in Patients with High-risk Non-muscle-invasive Urothelial Bladder Cancer

Background: Serum levels of neutrophils, platelets, and lymphocytes have been recognized as factors related to poor prognosis for many solid tumors, including bladder cancer (BC). Objective: To evaluate the prognostic role of the combination of the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR) in patients with high-risk non–muscle-invasive urothelial BC (NIMBC). Design, setting, and participants: A total of 1151 NMIBC patients who underwent first transurethral resection of the bladder tumor (TURBT) at 13 academic institutions between January 1, 2002 and December 31, 2012 were included in this analysis. The median follow-up was 48 mo.…

Can We Clinically Distinguish Anejaculation From Retrograde Ejaculation in Patients on α1A-Blockers Therapy for Lower Urinary Tract Symptoms?

To investigate the physiopathology of ejaculatory disorders (EjD) and discriminate between retrograde ejaculation (REj) and anejaculation (AEj) induced by α1A-blockers, through the association between the mean postorgasm seminal vesicle volume and the presence of sperm in midstream urine, in patients with moderate-to-severe lower urinary tract symptoms (LUTS) secondary to benign prostatic enlargement.Therapy-naïve male patients with LUTS and without previous EjD were treated with α1A-blockers. Pre- and post-treatment EjD were investigated through question 4 of the 4-item Male Sexual Function questionnaire and the Male Sexual Health Questionnaire for Ejaculatory Dysfunction Short Form (MSHQ-…

Does the Compliance to Intravesical BCG Differ between Common Clinical Practice and International Multicentric Trials?

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; The aim of this study was to analyze the reasons for intravesical BCG interruption in clinical practice. BCG for at least one year is advocated as the best regimen to treat high-risk non-muscle invasive bladder cancer (NMIBC). However, almost 50% of patients don't complete it. Toxicity accounts for 10% of dropouts in international trials. &lt;b&gt;&lt;i&gt;Materials and Methods:&lt;/i&gt;&lt;/b&gt; Patients with T1HG NMIBC undergoing 1-year BCG were enrolled in this study. BCG was administered for one year. Toxicity and causes of treatment interruption were recorded. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; A total of 411 patients we…

Type 2 diabetes mellitus predicts worse outcomes in patients with high-grade T1 bladder cancer receiving bacillus Calmette-Guérin after transurethral resection of the bladder tumor.

Objectives: The aim of this multicenter study was to investigate the prognostic role of type 2 diabetes mellitus (T2DM) comorbidity in a large multi-institutional cohort of patients with primary T1HG/G3 non–muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of the bladder (TURB). Materials and methods: A total of 1,172 patients with primary T1 HG/G3 who had NMIBC on re-TURB and who received adjuvant intravesical bacillus Calmette-Guérin therapy with maintenance were included. Endpoints were recurrence-free survival and progression-free survival. Results: A total of 231 (19.7%) of patients had T2DM prior to TURB. Five-year recurrence-free survival estimates were 12.5…

Single dose prulifloxacina can improve BCG tollerability

Tossicità e mantenimento nella chemioprofilassi endovescicale precoce (entro 6 ore) dopo TUR di carcinoma vescicale superficiale.

Sarcomatoid carcinoma of urinary bladder: Immunohistochemical study of an uncommon case

A case of sarcomatoid carcinoma of the bladder is reported herein. Immunohistochemical staining with human pancytokeratin antibody was negative, while vimentin staining was strongly positive, suggesting a diagnosis of sarcoma of the bladder. Further immunohistochemical analysis revealed positivity for AE1/AE3 cytokeratins, permitting a correct diagnosis of sarcomatoid carcinoma of the bladder. It can be difficult to distinguish between sarcomatoid carcinoma, undifferentiated carcinoma and sarcoma, particularly if the biopsy specimens are of small size. In rare cases, sarcomatoid tumors may express epithelial markers different from those revealed by human pancytokeratin staining. Copyright ©…

THE IMPACT OF NUMBER OF LYMPH NODE REMOVED IN THE DETECTION OF LYMPHNODE METASTASIS: A SENSITIVITY CURVE ANALYSIS.

Scopo del lavoro To assess the correct number of lymph nodes (LNs) to removed at Radical Cystectomy (RC) to ensure an accurate lymph nodes metastasis (LNM) staging. Materiali e metodi Between 1995 and 2012, 1016 RC for bladder cancer (BCa) were completed at a single tertiary care institution. Demographical, clinical and pathological variables were recorded for each patient. The relationship between the number of removed LNs and the probability to find a LNI at definitive pathology examination was assessed by receiver operating characteristic (ROC) analyses. The ROC curve coordinates were used to graph the probability of finding LNI according to the number of LNs removed and examined with a …

PRELIMINARY DATA ON PSA CHANGES DURING INTRAVESICAL THERAPY FOR NON-MUSCLE INVASIVE BLADDER CANCER

Introduction/Aim: Many factors can cause an increase of PSA independently from the presence of prostate cancer . The objective was to evaluate the fluctuation of the serum levels of PSA during adjuvant intravesical chemotherapy or immunotherapy. An increase of PSA due to intravesical BCG and up to 3 months later has been reported (1). Patients and Methods: Patients treated with intravesical chemotherapy or immunotherapy for non- muscle invasive bladder cancer (NMIBC) were entered in the study. Serum samples were collected before starting intravesical therapy, during therapy (within 3rd and 6th instillation) and 30 days after the end of the 6-week induction regimen and during maintenance reg…

Correlation between chronic prostatitis syndrome and pelvic venous disease: a survey of 2,554 urologic outpatients.

Objectives: In this study we evaluated the association between chronic prostatitis syndrome (CPS), varicocele and hemorrhoids as manifestations of a pelvic venous disease. Methods: Our retrospective study was based upon 2554 patients treated in two general urology clinics over the past 10 years. We have assessed the incidence of CPS among urological patients. Results: We found 483 patients with CPS, representing 18.9% of the total number of visits at the outpatient clinic. In this group the percentage of varicocele and hemorrhoids was 14.69 and 8.48%, whereas in a control group these figures were 5.02 and 5.84%, respectively (p &lt; 0.001 and 0.1054). Such a difference is statistically sign…

Urinary cytology and nuclear matrix protein 22 in the detection of bladder cancer recurrence other than transitional cell carcinoma

OBJECTIVE: To assess the value of nuclear matrix protein-22 (NMP22), compared with urinary cytology, in predicting the recurrence of bladder cancer that is not transitional cell carcinoma (non-TCC). PATIENTS AND METHODS: We tested the sensitivity, specificity and the predictive accuracy of NMP22 in the context of non-TCC bladder cancer recurrence, and compared it to the performance of urinary cytology. The study group comprised 2687 patients with history of non-muscle-invasive bladder cancer from 10 centres across four continents. RESULTS: The mean patient age was 64.8 years and 75.4% were men; of all patients, 513 (19.1%) had positive urinary cytology, 906 (33.7%) had a positive NMP22 test…

Intravesical chemotherapy for intermediate risk non-muscle invasive bladder cancer recurring after a first cycle of intravesical adjuvant therapy

Context: The therapeutic strategy in intermediate risk (IR) non-muscle invasive bladder cancer (NMIBC) recurring after intravesical therapy (IT) is not well defined. Most patients are usually retreated by Bacillus Calmette-Guerin (BCG). Aims: To evaluate the efficacy of intravesical chemotherapy (ICH) given at recurrence after the first cycle of ICH in IR-NMIBC recurring 6 months or later. Settings and Design: Retrospective analysis of the efficacy of ICH given after previous IT. Materials and Methods: The clinical files of IR-NMIBC patients recurring later than 6 months after transurethral resection (TUR) and IT and retreated by IT were reviewed. The patients should be at intermediate risk…

Chemioterapia adiuvante e fattori di rischio ambientale nel carcinoma vescicale superficiale a medio rischio di recidiva. Uno studio prospettico randomizzato del Gruppo Studi Tumori Urologici (GSTU)

Virtual Clinical and Precision Medicine Tumor Boards-Cloud-Based Platform-Mediated Implementation of Multidisciplinary Reviews Among Oncology Centers in the COVID-19 Era: Protocol for an Observational Study.

Background Multidisciplinary tumor boards play a pivotal role in the patient-centered clinical management and in the decision-making process to provide best evidence-based, diagnostic, and therapeutic care to patients with cancer. Among the barriers to achieve an efficient multidisciplinary tumor board, lack of time and geographical distance play a major role. Therefore, the elaboration of an efficient virtual multidisciplinary tumor board (VMTB) is a key point to successfully obtain an oncology team and implement a network among health professionals and institutions. This need is stronger than ever during the COVID-19 pandemic. Objective This paper presents a research protocol for an obse…

Adjuvant intravesical therapy in intermediate risk non-muscle invasive bladder cancer (NMIBC) recurring after first cycle of intravesical treatment.

Introduction and objectives The therapeutic management of intermediate risk NMI-BC recurring after intravesical therapy (IT) is not established. Cystectomy will be offered to patients at higher risk of progression but the majority will be retreated by IT. Although some Authors suggest BCG when intravesical chemotherapy (ICH) fails, some patients are retreated by ICH and some others repeat BCG adopted as first-line treatment. Not many studies have been published on this issue. The response to retreatment by intravesical therapy in terms of recurrence-free rate (RFR) and recurrence-free survival (RFS) is analyzed in 179 intermediate-risk patients. Materials and methods Only intermediate-risk …

ADIPONECTIN, LEPTIN AND MMP-3 PLASMATIC LEVELS CANNOT IDENTIFY HIGH-RISK PROSTATE CANCER IN PATIENTS UNDERGOING BIOPSY

Re: Urinary pH is Highly Associated With Tumor Recurrence During Intravesical Mitomycin C Therapy for Nonmuscle Invasive Bladder Tumor

The authors should be congratulated for their attention to basic and open questions on intravesical therapy of nonmuscle invasive bladder cancer. Intravesical delivery of chemotherapy remains partly empirical, and the pharmacokinetics poorly understood. Every attempt to optimize intravesical therapy should be welcomed. Expensive new strategies to deliver an effective therapeutic tumor dose are currently being explored.1,2 It is reasonable (and mandatory) first to consider and study the basic principles of pharmacokinetics. In this retrospective study Maeda et al investigate the role of pH on the efficacy of intravesical mitomycin C (MMC) in vivo. Their experience shows that urinary pH highe…

LA CISTECTOMIA “PROSTATE E SEMINAL SPARING” Pro: (Trieste) Contro: V. Serretta (Palermo)

Il tumore della vescica rimane una delle neoplasie più frequenti nell’ambito dell’oncologia urologica. Le strategie diagnostiche si stanno sempre più evolvendo e ci permettono di caratterizzare sempre meglio la neoplasia. Durante il corso verranno illustrate alcune nuovissime tecniche diagnostiche apparse recentemente. Dal punto di vista terapeutico l’intervento chirurgico demolitivo, la cistectomia, è sicuramente l’approccio di scelta per i tumori non muscolo invasivi ad alto ed altissimo rischio e per i tumori infiltranti. Tuttavia le tecniche si sono evolute come pure la preparazione del paziente. Durante il corso verranno discusse e dibattute due delle più interessanti e recenti tecnich…

Results of conservative treatment (transurethral resection plus adjuvant intravesical chemotherapy) in patients with primary T1, G3 transitional cell carcinoma of the bladder

Objectives. To evaluate a selected population of 50 consecutive patients with primary T1, G3 bladder transitional cell carcinoma in the absence of carcinoma in situ (Tis) treated with a bladder-sparing approach. Methods. Between January 1983 and December 1992, all patients were treated by transurethral resection (TUR) plus adjuvant intravesical chemotherapy over 1 year. In most cases, doxorubicin, epirubicin, and mitomycin were used alone or in combination. Results. At a mean follow-up period of 52 months (range, 18 to 126), 16 of 50 patients (32%) showed a recurrent superficial tumor. The recurrent lesion was of Stage T1 in 11 (22%) cases, but was a T1, G3 tumor only in 5 cases (10%). In 2…

A PROSPECTIVE STUDY ON THE INFLUENCE ON RECURRENCE OF QUITTING CIGARETTE SMOKING AT DIAGNOSIS OF PRIMARY NON MUSCLE INVASIVE BLADDER CANCER

Risultati di uno studio piolota di fase I-II con gemcitabina endovescicale nel tumore vescicale superficiale (Ta-T1).

Management of symptomatic benign prostatic hyperplasia in southern Italy: a retrospective analysis of the Sicilian-Calabrian Society of Urology (SSCU) of 32,000 patients.

&lt;i&gt;Introduction:&lt;/i&gt; The availability of new pharmacological and surgical options is responsible for important changes in the management of symptomatic benign prostate hyperplasia (BPH). The Sicilian-Calabrian Society of Urology performed a retrospective survey to assess the management of BPH in southern Italy in 1997 and 1998. &lt;i&gt;Patients and Methods:&lt;/i&gt; A 3-page questionnaire was sent to the 36 urological units of these two regions. The real number of patients treated was required. The numbers were checked with data obtained from the Health Regional Offices. &lt;i&gt;Results:&lt;/i&gt; Twenty-six urological units (72.3%) replied. Almost all patients underwent urin…

Pratica clinica e aderenza a Linee Guida nella diagnosi e terapia delle neoplasie vescicali non muscolo-invasive: report di uno studio ricognitivo basato su casi clinici

Clinical practice and adherence to the diagnosis and treatment of NMIBC guidelines: a report of a recognition based clinical cases study For non-muscle invasive bladder cancer, a disease with a considerable epidemiological and socio-economic impact, the introduction of the Guidelines has always evoked as a tool for the resolution of long-standing disputes in terms of diagnosis and therapy. Check the degree of routine clinical practice adherence to the Recommendations is for this disease, more than for other uro-oncology pathology, an urgent need felt by the urological community. To assess the level of Guidelines adherence’s, and study issues related to the paths of diagnosis and treatment o…

Cigarette Smoking and Drinking Water Source: Correlation with Clinical Features and Pathology of Superficial Bladder Carcinoma

&lt;i&gt;Objective:&lt;/i&gt; Water source and cigarette smoking are related to clinical characteristics and pathology of superficial transitional cell carcinoma of the bladder. &lt;i&gt;Methods:&lt;/i&gt; Tumor number, dimension, G-grade, T-stage, recurrences, cigarette smoking and water supply were recorded in patients harboring Ta–T1 G1–3 transitional cell carcinoma of the bladder. &lt;i&gt;Results:&lt;/i&gt; Of 577 patients, 61% had multiple and 36% recurrent tumors. Two hundred and forty-one patients (42%) were current smokers and 188 (33%) were former smokers. Bottled water was the only drinkable source for 249 (45%) patients, municipal water supply for 177 (32%), artesian wells for 3…

TERAPIA CONSERVATIVA DELL'UROTELIOMA VESCICALE T1G3. RISULTATI SU 235 PAZIENTI

Valore clinico della riduzione del PSA in soggetti candidati all’agobiopsia prostatica

Does Smoking Cessation at Primary Diagnosis Reduce the Recurrence Risk of Nonmuscle-Invasive Bladder Cancer? Results of a Prospective Study.

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Evidence that smoking cessation at first diagnosis of nonmuscle-invasive bladder cancer (NMIBC) reduces the risk of recurrence is lacking. The aim of our prospective study was to analyze the association between patients’ changes in smoking habits after diagnosis and recurrence-free survival (RFS). &lt;b&gt;&lt;i&gt;Patients:&lt;/i&gt;&lt;/b&gt; After transurethral resection of primary NMIBC, patients were classified as “ex-smokers,” i.e., those definitively stopping, and as “active smokers,” i.e., those continuing or restarting to smoke. Smoking status was reassessed every 3 months during the first year and every 6 months thereafter. Data …

The potential role of COVID-19 hygienic measures in reducing infective complications during hospitalization

Can we ameliorate the compliance to intravesical bcg maintenance? Analysis of the causes of treatment interruption in 160 consecutive patients.

Il carcinoma vescicale non muscolo invasivo

sj-jpg-1-tau-10.1177_1756287221995683 – Supplemental material for Fibronectin urothelial gene expression as a new reliable biomarker for early detection of local toxicity secondary to adjuvant intravesical therapy for non-muscle invasive bladder cancer

Supplemental material, sj-jpg-1-tau-10.1177_1756287221995683 for Fibronectin urothelial gene expression as a new reliable biomarker for early detection of local toxicity secondary to adjuvant intravesical therapy for non-muscle invasive bladder cancer by Fabrizio Di Maida, Cristina Scalici Gesolfo, Riccardo Tellini, Andrea Mari, Chiara Sanfilippo, Luca Lambertini, Antonio Andrea Grosso, Marco Carini, Andrea Minervini and Vincenzo Serretta in Therapeutic Advances in Urology

Distribution of smoking, water resource and other environmental factors in patients affected by superficial bladder cancer

INTRODUCTION AND OBJECTIVE: The pathogenetic role cancer of sigarette smoking and employment in bladder has been studied, however, that of other environmental factors is not well defined. Case-control studies require high numbers and are expensive. As a preliminary approach to larger case-control studies, the distribution of potential risk factors coming from environmental pollution among patients affected by superficial bladder cancer (TCCB) has been prospectively analized.