0000000000993074

AUTHOR

R. Colombo

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

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PROGNOSTIC FACTORS AND RISK GROUPS IN T1G3 PATIENTS INITIALLY TREATED WITH BCG: RESULTS OF A MULTICENTER RETROSPECTIVE SERIES IN 2530 PATIENTS

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

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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…

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Recurrence and progression according to stage at re-TUR in t1g3 bladder cancer patients treated with BCG: Not as bad as previously thought

Introduction & Objectives The goals of transurethral resection of a bladder tumour (TUR) are to completely resect the lesions and to make a correct diagnosis in order to adequately stage the patient. Persistent disease after TUR is not uncommon and is the reason why re-TUR is recommended in T1G3 patients. When there is T1 tumour in the re-TUR specimen, very high risks of progression (82%) have been reported1 and therefore cystectomy is considered to be mandatory. We analyse the tumour stage at re-TUR and the risk of recurrence, progression to muscle invasive disease and cancer specific mortality (CSM) in T1G3 patients treated with BCG. Material & Methods In our retrospective cohort …

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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 …

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

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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…

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

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

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Correction to: Potentially modifiable factors contributing to outcome from acute respiratory distress syndrome: the LUNG SAFE study (Intensive Care Medicine, (2016), 42, 12, (1865-1876), 10.1007/s00134-016-4571-5)

The members of the LUNG SAFE Investigators and the ESICM Trials Group were provided in such a way that they could not be indexed as collaborators on PubMed. The publisher apologizes for this error.

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Resolved versus confirmed ARDS after 24 h: insights from the LUNG SAFE study

Purpose: To evaluate patients with resolved versus confirmed ARDS, identify subgroups with substantial mortality risk, and to determine the utility of day 2 ARDS reclassification. Methods: Our primary objective, in this secondary LUNG SAFE analysis, was to compare outcome in patients with resolved versus confirmed ARDS after 24 h. Secondary objectives included identifying factors associated with ARDS persistence and mortality, and the utility of day 2 ARDS reclassification. Results: Of 2377 patients fulfilling the ARDS definition on the first day of ARDS (day 1) and receiving invasive mechanical ventilation, 503 (24%) no longer fulfilled the ARDS definition the next day, 52% of whom initial…

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The PROVENT-C19 registry: A study protocol for international multicenter SIAARTI registry on the use of prone positioning in mechanically ventilated patients with COVID-19 ARDS

Background The worldwide use of prone position (PP) for invasively ventilated patients with COVID-19 is progressively increasing from the first pandemic wave in everyday clinical practice. Among the suggested treatments for the management of ARDS patients, PP was recommended in the Surviving Sepsis Campaign COVID-19 guidelines as an adjuvant therapy for improving ventilation. In patients with severe classical ARDS, some authors reported that early application of prolonged PP sessions significantly decreases 28-day and 90-day mortality. Methods and analysis Since January 2021, the COVID19 Veneto ICU Network research group has developed and implemented nationally and internationally the “PRO…

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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…

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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 & 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 & 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 …

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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 …

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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 …

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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 …

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

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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…

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