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256 results on '"BRIGANTI , ALBERTO"'

1. Oncologic Outcomes of Incidental Versus Biopsy-diagnosed Grade Group 1 Prostate Cancer: A Multi-institutional Study

Author

Arts-assistenten Radiotherapie, Leni, Riccardo, Vertosick, Emily A., van den Bergh, Roderick C.N., Soeterik, Timo F.W., Heetman, Joris G., van Melick, Harm H.E., Roscigno, Marco, La Croce, Giovanni, Da Pozzo, Luigi F., Olivier, Jonathan, Zattoni, Fabio, Facco, Matteo, Dal Moro, Fabrizio, Chiu, Peter K.F., Wu, Xiaobo, Heidegger, Isabel, Giannini, Giulia, Bianchi, Lorenzo, Lampariello, Luca, Quarta, Leonardo, Salonia, Andrea, Montorsi, Francesco, Briganti, Alberto, Capitanio, Umberto, Carlsson, Sigrid V., Vickers, Andrew J., Gandaglia, Giorgio, EAU-YAU Prostate Cancer Working Group, Arts-assistenten Radiotherapie, Leni, Riccardo, Vertosick, Emily A., van den Bergh, Roderick C.N., Soeterik, Timo F.W., Heetman, Joris G., van Melick, Harm H.E., Roscigno, Marco, La Croce, Giovanni, Da Pozzo, Luigi F., Olivier, Jonathan, Zattoni, Fabio, Facco, Matteo, Dal Moro, Fabrizio, Chiu, Peter K.F., Wu, Xiaobo, Heidegger, Isabel, Giannini, Giulia, Bianchi, Lorenzo, Lampariello, Luca, Quarta, Leonardo, Salonia, Andrea, Montorsi, Francesco, Briganti, Alberto, Capitanio, Umberto, Carlsson, Sigrid V., Vickers, Andrew J., Gandaglia, Giorgio, and EAU-YAU Prostate Cancer Working Group

Published
2024

2. European Association of Nuclear Medicine Focus 5: Consensus on Molecular Imaging and Theranostics in Prostate Cancer

Author

Researchgr. Nucleaire Geneeskunde, Cancer, Oprea-Lager, Daniela Elena, MacLennan, Steven, Bjartell, Anders, Briganti, Alberto, Burger, Irene A., de Jong, Igle, De Santis, Maria, Eberlein, Uta, Emmett, Louise, Fizazi, Karim, Gillessen, Silke, Herrmann, Ken, Heskamp, Sandra, Iagaru, Andrei, Jereczek-Fossa, Barbara Alicja, Kunikowska, Jolanta, Lam, Marnix, Nanni, Cristina, O'Sullivan, Joe M., Panebianco, Valeria, Sala, Evis, Sathekge, Mike, Sosnowski, Roman, Tilki, Derya, Tombal, Bertrand, Treglia, Giorgio, Tunariu, Nina, Walz, Jochen, Yakar, Derya, Dierckx, Rudi, Sartor, Oliver, Fanti, Stefano, Researchgr. Nucleaire Geneeskunde, Cancer, Oprea-Lager, Daniela Elena, MacLennan, Steven, Bjartell, Anders, Briganti, Alberto, Burger, Irene A., de Jong, Igle, De Santis, Maria, Eberlein, Uta, Emmett, Louise, Fizazi, Karim, Gillessen, Silke, Herrmann, Ken, Heskamp, Sandra, Iagaru, Andrei, Jereczek-Fossa, Barbara Alicja, Kunikowska, Jolanta, Lam, Marnix, Nanni, Cristina, O'Sullivan, Joe M., Panebianco, Valeria, Sala, Evis, Sathekge, Mike, Sosnowski, Roman, Tilki, Derya, Tombal, Bertrand, Treglia, Giorgio, Tunariu, Nina, Walz, Jochen, Yakar, Derya, Dierckx, Rudi, Sartor, Oliver, and Fanti, Stefano

Published
2024

3. European Association of Nuclear Medicine Focus 5: Consensus on Molecular Imaging and Theranostics in Prostate Cancer

Author

Oprea-Lager, Daniela-Elena, MacLennan, Steven, Bjartell, Anders, Briganti, Alberto, Burger, Irene A; https://orcid.org/0000-0001-8029-8692, de Jong, Igle, De Santis, Maria; https://orcid.org/0000-0002-3196-1336, Eberlein, Uta, Emmett, Louise, Fizazi, Karim, Gillessen, Silke; https://orcid.org/0000-0001-5746-6555, Herrmann, Ken; https://orcid.org/0000-0002-9662-7259, Heskamp, Sandra, Iagaru, Andrei, Jereczek-Fossa, Barbara Alicja, Kunikowska, Jolanta, Lam, Marnix, Nanni, Cristina, O'Sullivan, Joe M, Panebianco, Valeria, Sala, Evis, Sathekge, Mike, Sosnowski, Roman, Tilki, Derya, Tombal, Bertrand, Treglia, Giorgio; https://orcid.org/0000-0001-9808-780X, Tunariu, Nina, Walz, Jochen, Yakar, Derya, Dierckx, Rudi, et al, Oprea-Lager, Daniela-Elena, MacLennan, Steven, Bjartell, Anders, Briganti, Alberto, Burger, Irene A; https://orcid.org/0000-0001-8029-8692, de Jong, Igle, De Santis, Maria; https://orcid.org/0000-0002-3196-1336, Eberlein, Uta, Emmett, Louise, Fizazi, Karim, Gillessen, Silke; https://orcid.org/0000-0001-5746-6555, Herrmann, Ken; https://orcid.org/0000-0002-9662-7259, Heskamp, Sandra, Iagaru, Andrei, Jereczek-Fossa, Barbara Alicja, Kunikowska, Jolanta, Lam, Marnix, Nanni, Cristina, O'Sullivan, Joe M, Panebianco, Valeria, Sala, Evis, Sathekge, Mike, Sosnowski, Roman, Tilki, Derya, Tombal, Bertrand, Treglia, Giorgio; https://orcid.org/0000-0001-9808-780X, Tunariu, Nina, Walz, Jochen, Yakar, Derya, Dierckx, Rudi, and et al

Abstract

BACKGROUND In prostate cancer (PCa), questions remain on indications for prostate-specific membrane antigen (PSMA) positron emission tomography (PET) imaging and PSMA radioligand therapy, integration of advanced imaging in nomogram-based decision-making, dosimetry, and development of new theranostic applications. OBJECTIVE We aimed to critically review developments in molecular hybrid imaging and systemic radioligand therapy, to reach a multidisciplinary consensus on the current state of the art in PCa. DESIGN, SETTING, AND PARTICIPANTS The results of a systematic literature search informed a two-round Delphi process with a panel of 28 PCa experts in medical or radiation oncology, urology, radiology, medical physics, and nuclear medicine. The results were discussed and ratified in a consensus meeting. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Forty-eight statements were scored on a Likert agreement scale and six as ranking options. Agreement statements were analysed using the RAND appropriateness method. Ranking statements were analysed using weighted summed scores. RESULTS AND LIMITATIONS After two Delphi rounds, there was consensus on 42/48 (87.5%) of the statements. The expert panel recommends PSMA PET to be used for staging the majority of patients with unfavourable intermediate and high risk, and for restaging of suspected recurrent PCa. There was consensus that oligometastatic disease should be defined as up to five metastases, even using advanced imaging modalities. The group agreed that [$^{177}$Lu]Lu-PSMA should not be administered only after progression to cabazitaxel and that [$^{223}$Ra]RaCl$_{2}$ remains a valid therapeutic option in bone-only metastatic castration-resistant PCa. Uncertainty remains on various topics, including the need for concordant findings on both [$^{18F}$]FDG and PSMA PET prior to [$^{177}$Lu]Lu-PSMA therapy. CONCLUSIONS There was a high proportion of agreement among a panel of experts on the use of molecular imaging and thera

Published
2024

4. Assessment of the VENUSS and GRANT models for individual prediction of cancer-specific survival in surgically treated nonmetastatic papillary renal cell carcinoma

Author

Tilki, Derya, Piccinelli, Mattia L.; Tappero, Stefano; Garcia, Cristina Cano; Barletta, Francesco; Incesu, Reha-Baris; Morra, Simone; Scheipner, Lukas; Tian, Zhe; Luzzago, Stefano; Mistretta, Francesco A.; Ferro, Matteo; Saad, Fred; Shariat, Shahrokh F.; Ahyai, Sascha; Longo, Nicola; Briganti, Alberto; Chun, Felix K. H.; Terrone, Carlo; de Cobelli, Ottavio; Musi, Gennaro; Karakiewicz, Pierre I., Koç University Hospital, School of Medicine, Tilki, Derya, Piccinelli, Mattia L.; Tappero, Stefano; Garcia, Cristina Cano; Barletta, Francesco; Incesu, Reha-Baris; Morra, Simone; Scheipner, Lukas; Tian, Zhe; Luzzago, Stefano; Mistretta, Francesco A.; Ferro, Matteo; Saad, Fred; Shariat, Shahrokh F.; Ahyai, Sascha; Longo, Nicola; Briganti, Alberto; Chun, Felix K. H.; Terrone, Carlo; de Cobelli, Ottavio; Musi, Gennaro; Karakiewicz, Pierre I., Koç University Hospital, and School of Medicine

Abstract

Background: guidelines recommend VENUSS and GRANT models for the prediction of cancer control outcomes after nephrectomy for nonmetastatic papillary renal cell carcinoma (pRCC). Objective: to test the ability of VENUSS and GRANT models to predict 5-yr cancer specific survival in a North American population. Design, setting, and participants: for this retrospective study, we identified 4184 patients with unilateral surgically treated nonmetastatic pRCC in the Surveillance, Epidemiology, and End Results database (2004-2019). Outcome measurements and statistical analysis: the original VENUSS and GRANT risk categories were applied to predict 5-yr cancer-specific survival. A cross-validation method was used to test the accuracy and calibration of the models and to conduct decision curve analyses for the study cohort. Results and limitations: the VENUSS and GRANT categories represented independent predictors of cancer-specific mortality. On cross-validation, the accuracy of the VENUSS and GRANT risk categories was 0.73 and 0.65, respectively. Both models showed good calibration and performed better than random predictions in decision curve analysis. Limitations include the retrospective nature of the study and the absence of a central pathological review. Conclusion: VENUSS risk categories fulfilled prognostic model criteria for predicting cancer-specific survival 5 yr after surgery in North American patients with non-metastatic pRCC as recommended by guidelines. Conversely, GRANT risk categories did not. Thus, VENUSS risk categories represent an important tool for counseling, follow-up planning, and patient selection for appropriate adjuvant trials in pRCC. Patient summary: we tested the ability of two validated methods (VENUSS and GRANT) to predict death due to papillary kidney cancer in a North American pop-ulation. The VENUSS risk categories showed good performance in predicting 5-year cancer-specific survival., NA

Published
2023

5. Mapping European Association of Urology Guideline Practice Across Europe: An Audit of Androgen Deprivation Therapy Use Before Prostate Cancer Surgery in 6598 Cases in 187 Hospitals Across 31 European Countries

Author

MacLennan, Steven, Azevedo, Nuno, Duncan, Eilidh, Dunsmore, Jennifer, Fullwood, Louise, Lumen, Nicolaas, Plass, Karin, Ribal, Maria J, Roobol, Monique J, Nieboer, Daan, Schouten, Natasha, Skolarus, Ted A, Smith, Emma Jane, N'Dow, James, Mottet, Nicolas, Briganti, Alberto, et al, Pan-European National Urological Society IMAGINE Collaborative, Eberli, Daniel; https://orcid.org/0000-0001-8866-8010, Oechslin, Pascal, MacLennan, Steven, Azevedo, Nuno, Duncan, Eilidh, Dunsmore, Jennifer, Fullwood, Louise, Lumen, Nicolaas, Plass, Karin, Ribal, Maria J, Roobol, Monique J, Nieboer, Daan, Schouten, Natasha, Skolarus, Ted A, Smith, Emma Jane, N'Dow, James, Mottet, Nicolas, Briganti, Alberto, et al, Pan-European National Urological Society IMAGINE Collaborative, Eberli, Daniel; https://orcid.org/0000-0001-8866-8010, and Oechslin, Pascal

Abstract

BACKGROUND Evidence-practice gaps exist in urology. We previously surveyed European Association of Urology (EAU) guidelines for strong recommendations underpinned by high-certainty evidence that impact patient experience for which practice variations were suspected. The recommendation "Do not offer neoadjuvant androgen deprivation therapy (ADT) before surgery for patients with prostate cancer" was prioritised for further investigation. ADT before surgery is neither clinically effective nor cost effective and has serious side effects. The first step in improving implementation problems is to understand their extent. A clear picture of practice regarding ADT before surgery across Europe is not available. OBJECTIVE To assess current ADT use before prostate cancer surgery in Europe. DESIGN, SETTING, AND PARTICIPANTS This was an observational cross-sectional study. We retrospectively audited recent ADT practices in a multicentre international setting. We used nonprobability purposive sampling, aiming for breadth in terms of low- versus high-volume, academic, versus community and public versus private centres. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Our primary outcome was adherence to the ADT recommendation. Descriptive statistics and a multilevel model were used to investigate differences between countries across different factors (volume, centre type, and funding type). Subgroup analyses were performed for patients with low, intermediate, and high risk, and for those with locally advanced prostate cancer. We also collected reasons for nonadherence. RESULTS AND LIMITATIONS We included 6598 patients with prostate cancer from 187 hospitals in 31 countries from January 1, 2017 to May 1, 2020. Overall, nonadherence was 2%, (range 0-32%). Most of the variability was found in the high-risk subgroup, for which nonadherence was 4% (range 0-43%). Reasons for nonadherence included attempts to improve oncological outcomes or preoperative tumour parameters; attempts to contro

Published
2023

6. Is there an impact of transperineal versus transrectal magnetic resonance imaging–targeted biopsy on the risk of ıpgrading in final pathology in prostate cancer patients undergoing radical prostatectomy? An European Association of Urology-Young Academic Urologists Prostate Cancer Working Group multi-institutional study

Author

Tilki, Derya, Zattoni, Fabio; Marra, Giancarlo; Martini, Alberto; Kasivisvanathan, Veeru; Grummet, Jeremy; Harkin, Timothy; Ploussard, Guillaume; Olivier, Jonathan; Chiu, Peter K.; Valerio, Massimo; Marquis, Alessandro; Gontero, Paolo; Guo, Hongqian; Zhuang, Junlong; Frydenberg, Mark; Moon, Daniel; Morlacco, Alessandro; Kretschmer, Alexander; Barletta, Francesco; Heidegger, Isabel; van den Bergh, Roderick; Dal Moro, Fabrizio; Briganti, Alberto; Montorsi, Francesco; Novara, Giacomo; Gandaglia, Giorgio, Koç University Hospital, School of Medicine, Tilki, Derya, Zattoni, Fabio; Marra, Giancarlo; Martini, Alberto; Kasivisvanathan, Veeru; Grummet, Jeremy; Harkin, Timothy; Ploussard, Guillaume; Olivier, Jonathan; Chiu, Peter K.; Valerio, Massimo; Marquis, Alessandro; Gontero, Paolo; Guo, Hongqian; Zhuang, Junlong; Frydenberg, Mark; Moon, Daniel; Morlacco, Alessandro; Kretschmer, Alexander; Barletta, Francesco; Heidegger, Isabel; van den Bergh, Roderick; Dal Moro, Fabrizio; Briganti, Alberto; Montorsi, Francesco; Novara, Giacomo; Gandaglia, Giorgio, Koç University Hospital, and School of Medicine

Abstract

Background: the concordance rates of transperineal (TP) versus transrectal (TR) prostate biopsies with radical prostatectomy (RP) specimen have been assessed poorly in men diagnosed with magnetic resonance imaging (MRI)-targeted biopsy (TBx). Objective: to evaluate International Society of Urological Pathology (ISUP) concordance rates between the final pathology at RP and MRI-TBx or MRI-TBx + random biopsy (RB) according to the biopsy approach. Design, setting, and participants: A multi-institutional database included patients diagnosed with TP or TR treated with RP. Intervention: TP-TBx or TR-TBx of the prostate. Outcome measurements and statistical analysis: The ISUP grade at biopsy was compared with the final pathology. A multivariable logistic regression analysis (MVA) was performed to assess the association between the biopsy approach (TP-TBx vs TR-TBx) and ISUP upgrading, downgrading, concordance, and clinically relevant increase (CRI). Results and limitations: Overall, 752 (59%) versus 530 (41%) patients underwent TR versus TP. At the MVA, TP-TBx was an independent predictor of upgrading (odds ratio [OR] 0.6, 95% confidence interval [CI] 0.4–0.9, p < 0.01) and improved concordance relative to the final pathology (OR 1.7, 95% CI 1.2–2.5, p < 0.01) after adjusting for age, cT stage, Prostate Imaging Reporting and Data System, number of targeted cores, prostate-specific antigen, and prostate volume. Moreover, TP-TBx was associated with a lower risk of CRI than TR-TBx (OR 0.7, p < 0.01). This held true when considering patients who underwent MRI-TBx + RB (OR 0.6, p < 0.01). The inclusion of men who had RP represents a potential selection bias. Conclusions: the adoption of TP-TBx compared with TR-TBx may reduce the risk of upgrading and improve the concordance of biopsy grade with the final pathology. The TP approach decreases the odds of CRI with improved patient selection for the correct active treatment. Patient summary: in this report, we evaluated whether tra, NA

Published
2023

7. Bibliometric analysis of academic journal recommendations and requirements for surgical and anesthesiologic adverse events reporting

Author

Sholklapper, Tamir N, Ballon, Jorge, Sayegh, Aref S, La Riva, Anibal, Perez, Laura C, Huang, Sherry, Eppler, Michael, Nelson, Gregg, Marchegiani, Giovanni, Hinchliffe, Robert, Gordini, Luca, Furrer, Marc, Brenner, Michael J, Dell-Kuster, Salome, Biyani, C Shekhar, Francis, Nader, Kaafarani, Haytham M A, Siepe, Matthias, Winter, Des, Sosa, Julie A, Bandello, Francesco, Siemens, Robert, Walz, Jochen, Briganti, Alberto, Gratzke, Christian, Abreu, Andre Luis, Desai, Mihir M, Sotelo, Rene, Agha, Riaz, Lillemoe, Keith D, Wexner, Steven, Collins, Gary S, Gill, Inderbir, and Cacciamani, Giovanni E

Subjects
Surgery, 610 Medicine & health, General Medicine
Abstract

BACKGROUND Standards for reporting surgical adverse events vary widely within the scientific literature. Failure to adequately capture adverse events hinders efforts to measure the safety of healthcare delivery and improve the quality of care. The aim of the present study is to assess the prevalence and typology of perioperative adverse event reporting guidelines among surgery and anesthesiology journals. MATERIALS AND METHODS In November 2021, three independent reviewers queried journal lists from the SCImago Journal & Country Rank (SJR) portal (www.scimagojr.com), a bibliometric indicator database for surgery and anesthesiology academic journals. Journal characteristics were summarized using SCImago, a bibliometric indicator database extracted from Scopus journal data. Quartile 1 (Q1) was considered the top quartile and Q4 bottom quartile based on the journal impact factor. Journal author guidelines were collected to determine whether adverse event reporting recommendations were included and, if so, the preferred reporting procedures. RESULTS Of 1,409 journals queried, 655 (46.5%) recommended surgical adverse event reporting. Journals most likely to recommend adverse event reporting were: 1) by category surgery (59.1%), urology (53.3%), and anesthesia (52.3%); 2) in top SJR quartiles (i.e. more influential); 3) by region, based in Western Europe (49.8%), North America (49.3%), and the Middle East (48.3%). CONCLUSIONS Surgery and anesthesiology journals do not consistently require or provide recommendations on perioperative adverse event reporting. Journal guidelines regarding adverse event reporting should be standardized and are needed to improve the quality of surgical adverse event reporting with the ultimate goal of improving patient morbidity and mortality.

Published
2023
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8. Management of patients with advanced prostate cancer. Part I: intermediate-/high-risk and locally advanced disease, biochemical relapse, and side effects of hormonal treatment: report of the Advanced Prostate Cancer Consensus Conference 2022

Author

Tilki, Derya, Gillessen, Silke; Bossi, Alberto; Davis, Ian D.; de Bono, Johann; Fizazi, Karim; James, Nicholas D.; Mottet, Nicolas; Shore, Neal; Small, Eric; Smith, Mathew; Sweeney, Christopher; Tombal, Bertrand; Antonarakis, Emmanuel S.; Aparicio, Ana M.; Armstrong, Andrew J.; Attard, Gerhardt; Beer, Tomasz M.; Beltran, Himisha; Bjartell, Anders; Blanchard, Pierre; Briganti, Alberto; Bristow, Rob G.; Bulbul, Muhammad; Caffo, Orazio; Castellano, Daniel; Castro, Elena; Cheng, Heather H.; Chi, Kim N.; Chowdhury, Simon; Clarke, Caroline S.; Clarke, Noel; Daugaard, Gedske; De Santis, Maria; Duran, Ignacio; Eeles, Ros; Efstathiou, Eleni; Efstathiou, Jason; Ngozi Ekeke, Onyeanunam; Evans, Christopher P.; Fanti, Stefano; Feng, Felix Y.; Fonteyne, Valerie; Fossati, Nicola; Frydenberg, Mark; George, Daniel; Gleave, Martin; Gravis, Gwenaelle; Halabi, Susan; Heinrich, Daniel; Herrmann, Ken; Higano, Celestia; Hofman, Michael S.; Horvath, Lisa G.; Hussain, Maha; Jereczek-Fossa, Barbara Alicja; Jones, Robert; Kanesvaran, Ravindran; Kellokumpu-Lehtinen, Pirkko-Liisa; Khauli, Raja B.; Klotz, Laurence; Kramer, Gero; Leibowitz, Raya; Logothetis, Christopher J.; Mahal, Brandon A.; Maluf, Fernando; Mateo, Joaquin; Matheson, David; Mehra, Niven; Merseburger, Axel; Morgans, Alicia K.; Morris, Michael J.; Mrabti, Hind; Mukherji, Deborah; Murphy, Declan G.; Murthy, Vedang; Nguyen, Paul L.; Oh, William K.; Ost, Piet; O'Sullivan, Joe; Padhani, Anwar R.; Pezaro, Carmel; Poon, Darren M.C.; Pritchard, Colin C.; Rabah, Danny M.; Rathkopf, Dana; Reiter, Robert E.; Rubin, Mark. A.; Ryan, Charles J.; Saad, Fred; Pablo Sade, Juan; Sartor, Oliver A.; Scher, Howard I.; Sharifi, Nima; Skoneczna, Iwona; Soule, Howard; Spratt, Daniel E.; Srinivas, Sandy; Sternberg, Cora N.; Steuber, Thomas; Suzuki, Hiroyoshi; Sydes, Matthew R.; Taplin, Mary-Ellen; Türkeri, Levent; Turco, Fabio; Uemura, Hiroji; Uemura, Hirotsugu; Ürün, Yüksel; Vale, Claire L.; van Oort, Inge; Vapiwala, Neha; Walz, Jochen; Yamoah, Kosj; Ye, Dingwei; Yu, School of Medicine, Tilki, Derya, Gillessen, Silke; Bossi, Alberto; Davis, Ian D.; de Bono, Johann; Fizazi, Karim; James, Nicholas D.; Mottet, Nicolas; Shore, Neal; Small, Eric; Smith, Mathew; Sweeney, Christopher; Tombal, Bertrand; Antonarakis, Emmanuel S.; Aparicio, Ana M.; Armstrong, Andrew J.; Attard, Gerhardt; Beer, Tomasz M.; Beltran, Himisha; Bjartell, Anders; Blanchard, Pierre; Briganti, Alberto; Bristow, Rob G.; Bulbul, Muhammad; Caffo, Orazio; Castellano, Daniel; Castro, Elena; Cheng, Heather H.; Chi, Kim N.; Chowdhury, Simon; Clarke, Caroline S.; Clarke, Noel; Daugaard, Gedske; De Santis, Maria; Duran, Ignacio; Eeles, Ros; Efstathiou, Eleni; Efstathiou, Jason; Ngozi Ekeke, Onyeanunam; Evans, Christopher P.; Fanti, Stefano; Feng, Felix Y.; Fonteyne, Valerie; Fossati, Nicola; Frydenberg, Mark; George, Daniel; Gleave, Martin; Gravis, Gwenaelle; Halabi, Susan; Heinrich, Daniel; Herrmann, Ken; Higano, Celestia; Hofman, Michael S.; Horvath, Lisa G.; Hussain, Maha; Jereczek-Fossa, Barbara Alicja; Jones, Robert; Kanesvaran, Ravindran; Kellokumpu-Lehtinen, Pirkko-Liisa; Khauli, Raja B.; Klotz, Laurence; Kramer, Gero; Leibowitz, Raya; Logothetis, Christopher J.; Mahal, Brandon A.; Maluf, Fernando; Mateo, Joaquin; Matheson, David; Mehra, Niven; Merseburger, Axel; Morgans, Alicia K.; Morris, Michael J.; Mrabti, Hind; Mukherji, Deborah; Murphy, Declan G.; Murthy, Vedang; Nguyen, Paul L.; Oh, William K.; Ost, Piet; O'Sullivan, Joe; Padhani, Anwar R.; Pezaro, Carmel; Poon, Darren M.C.; Pritchard, Colin C.; Rabah, Danny M.; Rathkopf, Dana; Reiter, Robert E.; Rubin, Mark. A.; Ryan, Charles J.; Saad, Fred; Pablo Sade, Juan; Sartor, Oliver A.; Scher, Howard I.; Sharifi, Nima; Skoneczna, Iwona; Soule, Howard; Spratt, Daniel E.; Srinivas, Sandy; Sternberg, Cora N.; Steuber, Thomas; Suzuki, Hiroyoshi; Sydes, Matthew R.; Taplin, Mary-Ellen; Türkeri, Levent; Turco, Fabio; Uemura, Hiroji; Uemura, Hirotsugu; Ürün, Yüksel; Vale, Claire L.; van Oort, Inge; Vapiwala, Neha; Walz, Jochen; Yamoah, Kosj; Ye, Dingwei; Yu, and School of Medicine

Abstract

Background: innovations in imaging and molecular characterisation and the evolution of new therapies have improved outcomes in advanced prostate cancer. Nonetheless, we continue to lack high-level evidence on a variety of clinical topics that greatly impact daily practice. To supplement evidence-based guidelines, the 2022 Advanced Prostate Cancer Consensus Conference (APCCC 2022) surveyed experts about key dilemmas in clinical management. Objective: to present consensus voting results for select questions from APCCC 2022. Design, setting, and participants: before the conference, a panel of 117 international prostate cancer experts used a modified Delphi process to develop 198 multiple-choice consensus questions on (1) intermediate- and high-risk and locally advanced prostate cancer, (2) biochemical recurrence after local treatment, (3) side effects from hormonal therapies, (4) metastatic hormone-sensitive prostate cancer, (5) nonmetastatic castration-resistant prostate cancer, (6) metastatic castration-resistant prostate cancer, and (7) oligometastatic and oligoprogressive prostate cancer. Before the conference, these questions were administered via a web-based survey to the 105 physician panel members (“panellists”) who directly engage in prostate cancer treatment decision-making. Herein, we present results for the 82 questions on topics 1–3. Outcome measurements and statistical analysis: consensus was defined as ?75% agreement, with strong consensus defined as ?90% agreement. Results and limitations: the voting results reveal varying degrees of consensus, as is discussed in this article and shown in the detailed results in the Supplementary material. The findings reflect the opinions of an international panel of experts and did not incorporate a formal literature review and meta-analysis. Conclusions: these voting results by a panel of international experts in advanced prostate cancer can help physicians and patients navigate controversial areas of clinical manage, We gratefully acknowledge the following organisations for providing financial support for the APCCC 2022: The City of Lugano and Movember Foundation. Ros Eeles is supported by a National Institute of Health Research grant to the Biomedical Research Centre at The Institute of Cancer Research and Royal Marsden NHS Foundation Trust. We also acknowledge sponsorship from several for-profit organisations for APCCC 2022, including Advanced Accelerator Applications, Amgen, Astellas, AstraZeneca, Bayer Health Care, Debio-pharm, MSD, Janssen Oncology, Myovant Sciences, Orion Pharma, Pfizer Oncology, Roche, Telix Innovations SA, Ferring Pharmaceuticals, Lantheus, and Tolmar. These for-profit organisations supported the conference financially but had no input on the scientific content or the final publication.

Published
2022

9. Novel Classification for Upper Tract Urothelial Carcinoma to Better Risk-stratify Patients Eligible for Kidney-sparing Strategies: An International Collaborative Study

Author

Marcq, Gautier, Foerster, Beat, Abufaraj, Mohammad, Matin, Surena F., Azizi, Mounsif, Gupta, Mohit, Li, Wei-Ming, Seisen, Thomas, Clinton, Timothy, Xylinas, Evanguelos, Mir, M. Carmen, Schweitzer, Donald, Mari, Andrea, Kimura, Shoji, Bandini, Marco, Mathieu, Romain, Ku, Ja H., Guruli, Georgi, Grabbert, Markus, Czech, Anna K., Muilwijk, Tim, Pycha, Armin, D'Andrea, David, Petros, Firas G., Spiess, Philippe E., Bivalacqua, Trinity, Wu, Wen-Jeng, Roupret, Morgan, Krabbe, Laura-Maria, Hendricksen, Kees, Egawa, Shin, Briganti, Alberto, Moschini, Marco, Graffeille, Vivien, Autorino, Riccardo, John, Patricia, Heidenreich, Axel, Chlosta, Piotr, Joniau, Steven, Soria, Francesco, Pierorazio, Phillip M., Shariat, Shahrokh F., Kassouf, Wassim, Marcq, Gautier, Foerster, Beat, Abufaraj, Mohammad, Matin, Surena F., Azizi, Mounsif, Gupta, Mohit, Li, Wei-Ming, Seisen, Thomas, Clinton, Timothy, Xylinas, Evanguelos, Mir, M. Carmen, Schweitzer, Donald, Mari, Andrea, Kimura, Shoji, Bandini, Marco, Mathieu, Romain, Ku, Ja H., Guruli, Georgi, Grabbert, Markus, Czech, Anna K., Muilwijk, Tim, Pycha, Armin, D'Andrea, David, Petros, Firas G., Spiess, Philippe E., Bivalacqua, Trinity, Wu, Wen-Jeng, Roupret, Morgan, Krabbe, Laura-Maria, Hendricksen, Kees, Egawa, Shin, Briganti, Alberto, Moschini, Marco, Graffeille, Vivien, Autorino, Riccardo, John, Patricia, Heidenreich, Axel, Chlosta, Piotr, Joniau, Steven, Soria, Francesco, Pierorazio, Phillip M., Shariat, Shahrokh F., and Kassouf, Wassim

Abstract

Background: The European Association of Urology risk stratification dichotomizes patients with upper tract urothelial carcinoma (UTUC) into two risk categories. Objective: To evaluate the predictive value of a new classification to better risk stratify patients eligible for kidney-sparing surgery (KSS). Design, setting, and participants: This was a retrospective study including 1214 patients from 21 centers who underwent ureterorenoscopy (URS) with biopsy followed by radical nephroureterectomy (RNU) for nonmetastatic UTUC between 2000 and 2017. Outcome measurements and statistical analysis: A multivariate logistic regression analysis identified predictors of muscle invasion (>= pT2) at RNU. The Youden index was used to identify cutoff points. Results and limitations: A total of 811 patients (67%) were male and the median age was 71 yr (interquartile range 63-77). The presence of non-organ-confined disease on preoperative imaging (p < 0.0001), sessile tumor (p < 0.0001), hydronephrosis (p 0.0003), high-grade cytology (p - 0.0043), or biopsy (p - 0.0174) and higher age at diagnosis (p = 0.029) were independently associated with >= pT2 at RNU. Tumor size was significantly associated with >= pT2 disease only in univariate analysis with a cutoff of 2 cm. Tumor size and all significant categorical variables defined the high-risk category. Tumor multifocality and a history of radical cystectomy help to dichotomize between low-risk and intermediate-risk categories. The odds ratio for muscle invasion were 5.5 (95% confidence interval [CI) 1.3-24.0; p = 0.023) for intermediate risk versus low risk, and 12.7 (95% CI 3.0-54.5; p = 0.0006) for high risk versus low risk. Limitations include the retrospective design and selection bias (all patients underwent RNU). Conclusions: Patients with low-risk UTUC represent ideal candidates for KSS, while some patients with intermediate-risk UTUC may also be considered. This classification needs further prospective validation and may help s

Published
2022

10. Definition and Impact on Oncologic Outcomes of Persistently Elevated Prostate-specific Antigen After Salvage Lymph Node Dissection for Node-only Recurrent Prostate Cancer After Radical Prostatectomy: Clinical Implications for Multimodal Therapy

Author

Bravi, Carlo A., Droghetti, Matteo, Fossati, Nicola, Gandaglia, Giorgio, Suardi, Nazareno, Mazzone, Elio, Cucchiara, Vito, Scuderi, Simone, Barletta, Francesco, Schiavina, Riccardo, Osmonov, Daniar, Juenemann, Klaus-Peter, Boeri, Luca, Karnes, R. Jeffrey, Kretschmer, Alexander, Buchner, Alexander, Stief, Christian, Hiester, Andreas, Nini, Alessandro, Albers, Peter, Devos, Gaetan, Joniau, Steven, Van Poppel, Hendrik, Grubmueller, Bernhard, Shariat, Shahrokh F., Heidenreich, Axel, Pfister, David, Tilki, Derya, Graefen, Markus, Gill, Inderbir S., Mottrie, Alexandre, Karakiewicz, Pierre, I, Montorsi, Francesco, Briganti, Alberto, Bravi, Carlo A., Droghetti, Matteo, Fossati, Nicola, Gandaglia, Giorgio, Suardi, Nazareno, Mazzone, Elio, Cucchiara, Vito, Scuderi, Simone, Barletta, Francesco, Schiavina, Riccardo, Osmonov, Daniar, Juenemann, Klaus-Peter, Boeri, Luca, Karnes, R. Jeffrey, Kretschmer, Alexander, Buchner, Alexander, Stief, Christian, Hiester, Andreas, Nini, Alessandro, Albers, Peter, Devos, Gaetan, Joniau, Steven, Van Poppel, Hendrik, Grubmueller, Bernhard, Shariat, Shahrokh F., Heidenreich, Axel, Pfister, David, Tilki, Derya, Graefen, Markus, Gill, Inderbir S., Mottrie, Alexandre, Karakiewicz, Pierre, I, Montorsi, Francesco, and Briganti, Alberto

Abstract

Background: The optimal definition and prognostic significance of persistently elevated prostate-specific antigen (PSA) after salvage lymph node dissection (sLND) for node-only recurrent prostate cancer (PCa) remain unknown. Objective: To assess the definition and clinical implications of persistently elevated PSA after sLND for node-only recurrent PCa after radical prostatectomy. Design, setting, and participants: The study included 579 patients treated with sLND at 11 high-volume centers between 2000 and 2016. Outcome measurements and statistical analysis: We assessed the linear relationship between the first PSA after sLND and death from PCa. Different definitions of PSA persistence were included in a multivariable model predicting cancer-specific mortality (CSM) after surgery to identify the best cutoff value. We investigated the association between PSA persistence and oncologic outcomes using multivariable regression models. Moreover, the effect of early androgen deprivation therapy (ADT) after sLND was tested according to PSA persistence status and estimated risk of CSM. Results and limitations: We found an inverse relationship between the first PSA after sLND and the probability of cancer-specific survival. PSA persistence defined as first postoperative PSA >= 0.3 ng/ml provided the best discrimination accuracy (C index 0.757). According to this cutoff, 331 patients (57%) experienced PSA persistence. The median follow-up for survivors was 48 mo (interquartile range 27-74). After adjusting for confounders, men with persistently elevated PSA had higher risk of clinical recurrence (hazard ratio [HR] 1.61), overall mortality (HR 2.20), and CSM (HR 2.59; all p < 0.001) after sLND. Early ADT administration after sLND improved survival only for patients with PSA persistence after surgery (HR 0.49; p = 0.024). Similarly, when PSA persistence status was included in multivariable models accounting for pathologic features, early ADT use after sLND was beneficial only fo

Published
2022

11. Predicting the Need for Biopsy to Detect Clinically Significant Prostate Cancer in Patients with a Magnetic Resonance Imaging-detected Prostate Imaging Reporting and Data System/Likert ≥3 Lesion: Development and Multinational External Validation of the Imperial Rapid Access to Prostate Imaging and Diagnosis Risk Score

Author

Arts-assistenten Radiotherapie, MS Radiotherapie, Cancer, Peters, Max, Eldred-Evans, David, Kurver, Piet, Falagario, Ugo Giovanni, Connor, Martin J, Shah, Taimur T, Verhoeff, Joost J C, Taimen, Pekka, Aronen, Hannu J, Knaapila, Juha, Montoya Perez, Ileana, Ettala, Otto, Stabile, Armando, Gandaglia, Giorgio, Fossati, Nicola, Martini, Alberto, Cucchiara, Vito, Briganti, Alberto, Lantz, Anna, Picker, Wolfgang, Haug, Erik Skaaheim, Nordström, Tobias, Tanaka, Mariana Bertoncelli, Reddy, Deepika, Bass, Edward, van Rossum, Peter S N, Wong, Kathie, Tam, Henry, Winkler, Mathias, Gordon, Stephen, Qazi, Hasan, Boström, Peter J, Jambor, Ivan, Ahmed, Hashim U, Arts-assistenten Radiotherapie, MS Radiotherapie, Cancer, Peters, Max, Eldred-Evans, David, Kurver, Piet, Falagario, Ugo Giovanni, Connor, Martin J, Shah, Taimur T, Verhoeff, Joost J C, Taimen, Pekka, Aronen, Hannu J, Knaapila, Juha, Montoya Perez, Ileana, Ettala, Otto, Stabile, Armando, Gandaglia, Giorgio, Fossati, Nicola, Martini, Alberto, Cucchiara, Vito, Briganti, Alberto, Lantz, Anna, Picker, Wolfgang, Haug, Erik Skaaheim, Nordström, Tobias, Tanaka, Mariana Bertoncelli, Reddy, Deepika, Bass, Edward, van Rossum, Peter S N, Wong, Kathie, Tam, Henry, Winkler, Mathias, Gordon, Stephen, Qazi, Hasan, Boström, Peter J, Jambor, Ivan, and Ahmed, Hashim U

Published
2022

12. Updating and Integrating Core Outcome Sets for Localised, Locally Advanced, Metastatic, and Nonmetastatic Castration-resistant Prostate Cancer: An Update from the PIONEER Consortium

Author

MS Urologische Oncologie, Cancer, Beyer, Katharina, Moris, Lisa, Lardas, Michael, Omar, Muhammad Imran, Healey, Jemma, Tripathee, Sheela, Gandaglia, Giorgio, Venderbos, Lionne D F, Vradi, Eleni, van den Broeck, Thomas, Willemse, Peter-Paul, Antunes-Lopes, Tiago, Pacheco-Figueiredo, Luis, Monagas, Serenella, Esperto, Francesco, Flaherty, Stephen, Devecseri, Zsuzsanna, Lam, Thomas B L, Williamson, Paula R, Heer, Rakesh, Smith, Emma J, Asiimwe, Alex, Huber, Johannes, Roobol, Monique J, Zong, Jihong, Mason, Malcolm, Cornford, Philip, Mottet, Nicolas, MacLennan, Sara J, N'Dow, James, Briganti, Alberto, MacLennan, Steven, Van Hemelrijck, Mieke, PIONEER Consortium, MS Urologische Oncologie, Cancer, Beyer, Katharina, Moris, Lisa, Lardas, Michael, Omar, Muhammad Imran, Healey, Jemma, Tripathee, Sheela, Gandaglia, Giorgio, Venderbos, Lionne D F, Vradi, Eleni, van den Broeck, Thomas, Willemse, Peter-Paul, Antunes-Lopes, Tiago, Pacheco-Figueiredo, Luis, Monagas, Serenella, Esperto, Francesco, Flaherty, Stephen, Devecseri, Zsuzsanna, Lam, Thomas B L, Williamson, Paula R, Heer, Rakesh, Smith, Emma J, Asiimwe, Alex, Huber, Johannes, Roobol, Monique J, Zong, Jihong, Mason, Malcolm, Cornford, Philip, Mottet, Nicolas, MacLennan, Sara J, N'Dow, James, Briganti, Alberto, MacLennan, Steven, Van Hemelrijck, Mieke, and PIONEER Consortium

Published
2022

13. What Experts Think About Prostate Cancer Management During the COVID-19 Pandemic: Report from the Advanced Prostate Cancer Consensus Conference 2021 (vol 82, pg 6, 2022)

Author

Turco, Fabio, Armstrong, Andrew, Attard, Gerhardt, Beer, Tomasz M., Beltran, Himisha, Bjartell, Anders, Bossi, Alberto, Briganti, Alberto, Bristow, Rob G., Bulbul, Muhammad, Caffo, Orazio, Chi, Kim N., Clarke, Caroline, Clarke, Noel, Davis, Ian D., de Bono, Johann, Duran, Ignacio, Eeles, Ros, Efstathiou, Eleni, Efstathiou, Jason, Evans, Christopher P., Fanti, Stefano, Feng, Felix Y., Fizazi, Karim, Frydenberg, Mark, George, Dan, Gleave, Martin, Halabi, Susan, Heinrich, Daniel, Higano, Celestia, Hofman, Michael S., Hussain, Maha, James, Nicholas, Jones, Rob, Kanesvaran, Ravindran, Khauli, Raja B., Klotz, Laurence, Leibowitz, Raya, Logothetis, Christopher, Maluf, Fernando, Millman, Robin, Morgans, Alicia K., Morris, Michael J., Mottet, Nicolas, Mrabti, Hind, Murphy, Declan G., Murthy, Vedang, Oh, William K., Ekeke, Onyeanunam Ngozi, Ost, Piet, O'Sullivan, Joe M., Padhani, Anwar R., Parker, Christopher, Poon, Darren M. C., Pritchard, Colin C., Rabah, Danny M., Rathkopf, Dana, Reiter, Robert E., Rubin, Mark, Ryan, Charles J., Saad, Fred, Sade, Juan Pablo, Sartor, Oliver, Scher, Howard I., Shore, Neal, Skoneczna, Iwona, Small, Eric, Smith, Matthew, Soule, Howard, Spratt, Daniel, Sternberg, Cora N., Suzuki, Hiroyoshi, Sweeney, Christopher, Sydes, Matthew, Taplin, Mary-Ellen, Tilki, Derya, Tombal, Bertrand, Turkeri, Levent, Uemura, Hiroji, Uemura, Hirotsugu, van Oort, Inge, Yamoah, Kosj, Ye, Dingwei, Zapatero, Almudena, Gillessen, Silke, Omlin, Aurelius, and Acibadem University Dspace

Published
2022
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14. Corrigendum to 'What Experts Think About Prostate Cancer Management During the COVID-19 Pandemic: Report from the Advanced Prostate Cancer Consensus Conference 2021' [Eur Urol 2022]

Author

Turco, Fabio, Armstrong, Andrew, Attard, Gerhardt, Beer, Tomasz M, Beltran, Himisha, Bjartell, Anders, Bossi, Alberto, Briganti, Alberto, Bristow, Rob G, Bulbul, Muhammad, Caffo, Orazio, Chi, Kim N, Clarke, Caroline, Clarke, Noel, Davis, Ian D, de Bono, Johann, Duran, Ignacio, Eeles, Ros, Efstathiou, Eleni, Efstathiou, Jason, Evans, Christopher P, Fanti, Stefano, Feng, Felix Y, Fizazi, Karim, Frydenberg, Mark, George, Dan, Gleave, Martin, Halabi, Susan, Heinrich, Daniel, Higano, Celestia, Hofman, Michael S, Hussain, Maha, James, Nicholas, Jones, Rob, Kanesvaran, Ravindran, Khauli, Raja B, Klotz, Laurence, Leibowitz, Raya, Logothetis, Christopher, Maluf, Fernando, Millman, Robin, Morgans, Alicia K, Morris, Michael J, Mottet, Nicolas, Mrabti, Hind, Murphy, Declan G, Murthy, Vedang, Oh, William K, Ekeke, Onyeanunam Ngozi, Ost, Piet, O'Sullivan, Joe M, Padhani, Anwar R, Parker, Christopher, Poon, Darren M C, Pritchard, Colin C, Rabah, Danny M, Rathkopf, Dana, Reiter, Robert E, Rubin, Mark, Ryan, Charles J, Saad, Fred, Sade, Juan Pablo, Sartor, Oliver, Scher, Howard I, Shore, Neal, Skoneczna, Iwona, Small, Eric, Smith, Matthew, Soule, Howard, Spratt, Daniel, Sternberg, Cora N, Suzuki, Hiroyoshi, Sweeney, Christopher, Sydes, Matthew, Taplin, Mary-Ellen, Tilki, Derya, Tombal, Bertrand, Türkeri, Levent, Uemura, Hiroji, Uemura, Hirotsugu, van Oort, Inge, Yamoah, Kosj, Ye, Dingwei, Zapatero, Almudena, Gillessen, Silke, Omlin, Aurelius, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, and UCL - (SLuc) Service d'urologie

Subjects
610 Medicine & health, 610 Medizin und Gesundheit
Published
2022
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15. Pretreatment Risk Stratification for Endoscopic Kidney-sparing Surgery in Upper Tract Urothelial Carcinoma: An International Collaborative Study

Author

Foerster, Beat, Abufaraj, Mohammad, Matin, Surena F., Azizi, Mounsif, Gupta, Mohit, Li, Wei-Ming, Seisen, Thomas, Clinton, Timothy, Xylinas, Evanguelos, Mir, M. Carmen, Schweitzer, Donald, Mari, Andrea, Kimura, Shoji, Bandini, Marco, Mathieu, Romain, Ku, Ja H., Marcq, Gautier, Guruli, Georgi, Grabbert, Markus, Czech, Anna K., Muilwijk, Tim, Pycha, Armin, D'Andrea, David, Petros, Firas G., Spiess, Philippe E., Bivalacqua, Trinity, Wu, Wen-Jeng, Roupret, Morgan, Krabbe, Laura-Maria, Hendricksen, Kees, Egawa, Shin, Briganti, Alberto, Moschini, Marco, Graffeille, Vivien, Kassouf, Wassim, Autorino, Riccardo, Heidenreich, Axel, Chlosta, Piotr, Joniau, Steven, Soria, Francesco, Pierorazio, Phillip M., Shariat, Shahrokh F., Foerster, Beat, Abufaraj, Mohammad, Matin, Surena F., Azizi, Mounsif, Gupta, Mohit, Li, Wei-Ming, Seisen, Thomas, Clinton, Timothy, Xylinas, Evanguelos, Mir, M. Carmen, Schweitzer, Donald, Mari, Andrea, Kimura, Shoji, Bandini, Marco, Mathieu, Romain, Ku, Ja H., Marcq, Gautier, Guruli, Georgi, Grabbert, Markus, Czech, Anna K., Muilwijk, Tim, Pycha, Armin, D'Andrea, David, Petros, Firas G., Spiess, Philippe E., Bivalacqua, Trinity, Wu, Wen-Jeng, Roupret, Morgan, Krabbe, Laura-Maria, Hendricksen, Kees, Egawa, Shin, Briganti, Alberto, Moschini, Marco, Graffeille, Vivien, Kassouf, Wassim, Autorino, Riccardo, Heidenreich, Axel, Chlosta, Piotr, Joniau, Steven, Soria, Francesco, Pierorazio, Phillip M., and Shariat, Shahrokh F.

Abstract

Background: Several groups have proposed features to identify low-risk patients who may benefit from endoscopic kidney-sparing surgery in upper tract urothelial carcinoma (UTUC). Objective: To evaluate standard risk stratification features, develop an optimal model to identify >= pT2/N+ stage at radical nephroureterectomy (RNU), and compare it with the existing unvalidated models. Design, setting, and participants: This was a collaborative retrospective study that included 1214 patients who underwent ureterorenoscopy with biopsy followed by RNU for nonmetastatic UTUC between 2000 and 2017. Outcome measurements and statistical analysis: We performed multiple imputation of chained equations for missing data and multivariable logistic regression analysis with a stepwise selection algorithm to create the optimal predictive model. The area under the curve and a decision curve analysis were used to compare the models. Results and limitations: Overall, 659 (54.3%) and 555 (45.7%) patients had <= pT1N0/Nx and >= pT2/N+ disease, respectively. In the multivariable logistic regression analysis of our model, age (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.0-1.03, p = 0.013), high-grade biopsy (OR 1.81, 95% CI 1.37-2.40, p < 0.001), biopsy cT1+ staging (OR 3.23, 95% CI 1.93-5.41, p < 0.001), preoperative hydronephrosis (OR 1.37 95% CI 1.04-1.80, p = 0.024), tumor size (OR 1.09, 95% CI 1.01-1.17, p = 0.029), invasion on imaging (OR 5.10, 95% CI 3.32-7.81, p < 0.001), and sessile architecture (OR 2.31, 95% CI 1.58-3.36, p < 0.001) were significantly associated with >= pT2/pN+ disease. Compared with the existing models, our model had the highest performance accuracy (75% vs 66-71%) and an additional clinical net reduction (four per 100 patients). Conclusions: Our proposed risk-stratification model predicts the risk of harboring >= pT2/N+ UTUC with reliable accuracy and a clinical net benefit outperforming the current risk-stratification models. Patient summary: We develop

Published
2021

16. Impact of Pelvic Lymph Node Dissection and Its Extent on Perioperative Morbidity in Patients Undergoing Radical Prostatectomy for Prostate Cancer: A Comprehensive Systematic Review and Meta-analysis

Author

Cacciamani, Giovanni E., Maas, Marissa, Nassiri, Nima, Ortega, David, Gill, Karanvir, Dell'Oglio, Paolo, Thalmann, George N., Heidenreich, Axel, Eastham, James A., Evans, Christopher P., Karnes, R. Jeffrey, Abreu, Andre L. De Castro, Briganti, Alberto, Artibani, Walter, Gill, Inderbir, Montorsi, Francesco, Cacciamani, Giovanni E., Maas, Marissa, Nassiri, Nima, Ortega, David, Gill, Karanvir, Dell'Oglio, Paolo, Thalmann, George N., Heidenreich, Axel, Eastham, James A., Evans, Christopher P., Karnes, R. Jeffrey, Abreu, Andre L. De Castro, Briganti, Alberto, Artibani, Walter, Gill, Inderbir, and Montorsi, Francesco

Abstract

Context: Pelvic lymph node dissection (PLND) yields the most accurate staging in patients undergoing radical prostatectomy (RP) for prostate cancer (PCa), although it can be associated with morbidity. Objective: To systematically evaluate the impact of PLND extent on perioperative morbidity in patients undergoing RP. A new PLND-related complication assessment tool is proposed. Evidence acquisition: A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) was conducted. MEDLINE/ PubMed, Scopus, Embase and Web of Science databases were searched to yield studies discussing perioperative complications following RP and PLND. The extent of PLND was classified according to the European Association of Urology PCa guidelines. Studies were categorized according to the extent of PLND. Intra- and postoperative complications were classified as strongly, likely, or unlikely related to PLND. Anatomical site of perioperative complications was recorded. A cumulative meta-analysis of comparative studies was conducted using Review Manager 5.3 (Cochrane Collaboration, Oxford, UK). Evidence synthesis: Our search generated 3645 papers, with 176 studies meeting the inclusion criteria. Details of 77 303 patients were analyzed. Of these studies, 84 (47.7%), combining data on 28 428 patients, described intraoperative complications as an outcome of interest. Overall, 534 (1.8%) patients reported one or more intraoperative complications. Postoperative complications were reported in 151 (85.7%) studies, combining data on 73 629 patients. Overall, 10 401 (14.1%) patients reported one or more postoperative complication. The most reported postoperative complication strongly related to PLND was lymphocele (90.6%). The pooled metaanalysis revealed that RP + limited PLND/standard PLND had a significantly decreased risk of experiencing any intraoperative complication (risk ratio [RR]: 0.55; p = 0.01) and postoperative complication strongly relate

Published
2021

17. Contemporary Treatment Patterns and Outcomes for Patients with Penile Squamous Cell Carcinoma: Identifying Management Gaps to Promote Multi-institutional Collaboration

Author

Bandini, Marco, Zhu, Yao, Ye, Ding-Wei, Ornellas, Antonio A., Watkin, Nick, Ayres, Benjamin, Hakenberg, Oliver W., Heidenreich, Axel, Raggi, Daniele, Giannatempo, Patrizia, Marandino, Laura, Haidl, Friederike, Pederzoli, Filippo, Briganti, Alberto, Montorsi, Francesco, Chipollini, Juan, Azizi, Mounsif, De Meerleer, Gert, Brouwer, Oscar R., Grass, G. Daniel, Johnstone, Peter A., Albersen, Maarten, Spiess, Philippe E., Necchi, Andrea, Bandini, Marco, Zhu, Yao, Ye, Ding-Wei, Ornellas, Antonio A., Watkin, Nick, Ayres, Benjamin, Hakenberg, Oliver W., Heidenreich, Axel, Raggi, Daniele, Giannatempo, Patrizia, Marandino, Laura, Haidl, Friederike, Pederzoli, Filippo, Briganti, Alberto, Montorsi, Francesco, Chipollini, Juan, Azizi, Mounsif, De Meerleer, Gert, Brouwer, Oscar R., Grass, G. Daniel, Johnstone, Peter A., Albersen, Maarten, Spiess, Philippe E., and Necchi, Andrea

Published
2021

18. Association Between Human Papillomavirus Infection and Outcome of Perioperative Nodal Radiotherapy for Penile Carcinoma

Author

Bandini, Marco, Ross, Jeffrey S., Zhu, Yao, Ye, Ding-Wei, Ornellas, Antonio A., Watkin, Nick, Ayres, Benjamin A., Hakenberg, Oliver W., Heidenreich, Axel, Salvioni, Roberto, Catanzaro, Mario, Raggi, Daniele, Giannatempo, Patrizia, Marandino, Laura, Haidl, Friederike, Pederzoli, Filippo, Briganti, Alberto, Montorsi, Francesco, Chipollini, Juan, Azizi, Mounsif, De Meerleer, Gert, Brouwer, Oscar R., Grass, G. Daniel, Johnstone, Peter A., Albersen, Maarten, Spiess, Philippe E., Necchi, Andrea, Bandini, Marco, Ross, Jeffrey S., Zhu, Yao, Ye, Ding-Wei, Ornellas, Antonio A., Watkin, Nick, Ayres, Benjamin A., Hakenberg, Oliver W., Heidenreich, Axel, Salvioni, Roberto, Catanzaro, Mario, Raggi, Daniele, Giannatempo, Patrizia, Marandino, Laura, Haidl, Friederike, Pederzoli, Filippo, Briganti, Alberto, Montorsi, Francesco, Chipollini, Juan, Azizi, Mounsif, De Meerleer, Gert, Brouwer, Oscar R., Grass, G. Daniel, Johnstone, Peter A., Albersen, Maarten, Spiess, Philippe E., and Necchi, Andrea

Abstract

Background: Data on the impact of human papillomavirus (HPV) infection status and outcomes for perioperative treatments for patients with lymph node-involved penile squamous-cell carcinoma (PSCC) are lacking. Objective: To analyze the benefit from perioperative radiotherapy (RT) for PSCC according to HPV infection status. Design, setting, and participants: In an international multicenter database of 1254 patients with PSCC who received inguinal lymph node dissection (ILND), 507 had suitable clinical information. Intervention: ILND, with or without chemotherapy or RT for involved lymph nodes. Outcome measurements and statistical analysis: Kaplan-Meier and restricted mean survival time (RMST) analyses for overall survival (OS) were performed for all patients and after propensity score-matching (PSM; n = 136), for which patient age, histology, type of penile surgical procedure, pathological tumor and nodal stage, ILND laterality, pelvic LND, and perioperative treatment were taken into account when assessing differences between HPV+ and HPV- patients. Finally, we looked at genomic alterations in PSCC using data from the Foundation Medicine database (n = 199) to characterize HPV+ PSCC. Results and limitations: Patients with HPV+ PSCC (n = 86; 17%) had lower clinical N stage (p < 0.001) and inguinal lymph node metastasis density (p < 0.001). Perioperative RT was delivered in 49 patients (9.7%), with the vast majority receiving adjuvant RT (n = 40). HPV+ patients had similar median OS (p = 0.1) but longer RMST than HPV- patients at different time points. Nevertheless, HPV+ patients treated with perioperative RT exhibited longer median OS (p = 0.015) and longer RMST compared to HPV- patients. In the PSM cohorts, HPV+ status remained significantly associated with longer OS after RT. The HPV- PSCC group had a higher frequency of TP53 mutations compared to HPV+ PSCC (75% vs 15%; p < 0.001). The results are limited by the retrospective nature of the data. Conclusions: Periopera

Published
2021

19. EAU-ESMO consensus statements on the management of advanced and variant bladder cancer-an international collaborative multistakeholder effort† EU*ACME: under the auspices of the EAU-ESMO guidelines committees

Author

Witjes, J Alfred, Babjuk, Marek, Bellmunt, Joaquim, Bruins, H Maxim, De Reijke, Theo M, De Santis, Maria, Gillessen, Silke, James, Nicholas, Maclennan, Steven, Palou, Juan, Powles, Tom, Ribal, Maria J, Shariat, Shahrokh F, Der Kwast, Theo Van, Xylinas, Evanguelos, Agarwal, Neeraj, Arends, Tom, Bamias, Aristotle, Birtle, Alison, Black, Peter C, Bochner, Bernard H, Bolla, Michel, Boormans, Joost L, Bossi, Alberto, Briganti, Alberto, Brummelhuis, Iris, Burger, Max, Castellano, Daniel, Cathomas, Richard, Chiti, Arturo, Choudhury, Ananya, Compérat, Eva, Crabb, Simon, Culine, Stephane, De Bari, Berardino, De Blok, Willem, J L De Visschere, Pieter, Decaestecker, Karel, Dimitropoulos, Konstantinos, Dominguez-Escrig, Jose L, Fanti, Stefano, Fonteyne, Valerie, Frydenberg, Mark, Futterer, Jurgen J, Gakis, Georgios, Geavlete, Bogdan, Gontero, Paolo, Grubmüller, Bernhard, Hafeez, Shaista, Hansel, Donna E, Hartmann, Arndt, Hayne, Dickon, Henry, Ann M, Hernandez, Virginia, Herr, Harry, Herrmann, Ken, Hoskin, Peter, Huguet, Jorge, Jereczek-Fossa, Barbara A, Jones, Rob, Kamat, Ashish M, Khoo, Vincent, Kiltie, Anne E, Krege, Susanne, Ladoire, Sylvain, Lara, Pedro C, Leliveld, Annemarie, Linares-Espinós, Estefania, Løgager, Vibeke, Lorch, Anja, Loriot, Yohann, Meijer, Richard, Mir, M Carmen, Moschini, Marco, Mostafid, Hugh, Müller, Arndt-Christian, Müller, Christoph R, N'Dow, James, Necchi, Andrea, Neuzillet, Yann, Oddens, Jorg R, Oldenburg, Jan, Osanto, Susanne, J G Oyen, Wim, Pacheco-Figueiredo, Luís, Pappot, Helle, Patel, Manish I, Pieters, Bradley R, Plass, Karin, Remzi, Mesut, Retz, Margitta, Richenberg, Jonathan, Rink, Michael, Roghmann, Florian, Rosenberg, Jonathan E, Rouprêt, Morgan, Rouvière, Olivier, Salembier, Carl, Salminen, Antti, Sargos, Paul, Sengupta, Shomik, Sherif, Amir, Smeenk, Robert J, Smits, Anita, Stenzl, Arnulf, Thalmann, George N, Tombal, Bertrand, Turkbey, Baris, Lauridsen, Susanne Vahr, Valdagni, Riccardo, Der Heijden, Antoine G Van, Van Poppel, Hein, Vartolomei, Mihai D, Veskimäe, Erik, Vilaseca, Antoni, Rivera, Franklin A Vives, Wiegel, Thomas, Wiklund, Peter, Williams, Andrew, Zigeuner, Richard, and Horwich, Alan

Subjects
education
Abstract

Background: \ud Although guidelines exist for advanced and variant bladder cancer management, evidence is limited/conflicting in some areas and the optimal approach remains controversial.\ud \ud Objective: \ud To bring together a large multidisciplinary group of experts to develop consensus statements on controversial topics in bladder cancer management.\ud \ud Design: \ud A steering committee compiled proposed statements regarding advanced and variant bladder cancer management which were assessed by 113 experts in a Delphi survey. Statements not reaching consensus were reviewed; those prioritised were revised by a panel of 45 experts prior to voting during a consensus conference.\ud \ud Setting: \ud Online Delphi survey and consensus conference.\ud \ud Participants: \ud The European Association of Urology (EAU), the European Society for Medical Oncology (ESMO), experts in bladder cancer management.\ud \ud Outcome measurements and statistical analysis: \ud Statements were ranked by experts according to their level of agreement: 1–3 (disagree), 4–6 (equivocal), and 7–9 (agree). A priori (level 1) consensus was defined as ≥70% agreement and ≤15% disagreement, or vice versa. In the Delphi survey, a second analysis was restricted to stakeholder group(s) considered to have adequate expertise relating to each statement (to achieve level 2 consensus).\ud \ud Results and limitations: \ud Overall, 116 statements were included in the Delphi survey. Of these statements, 33 (28%) achieved level 1 consensus and 49 (42%) achieved level 1 or 2 consensus. At the consensus conference, 22 of 27 (81%) statements achieved consensus. These consensus statements provide further guidance across a broad range of topics, including the management of variant histologies, the role/limitations of prognostic biomarkers in clinical decision making, bladder preservation strategies, modern radiotherapy techniques, the management of oligometastatic disease, and the evolving role of checkpoint inhibitor therapy in metastatic disease.\ud \ud Conclusions: \ud These consensus statements provide further guidance on controversial topics in advanced and variant bladder cancer management until a time when further evidence is available to guide our approach.\ud \ud Patient summary: \ud This report summarises findings from an international, multistakeholder project organised by the EAU and ESMO. In this project, a steering committee identified areas of bladder cancer management where there is currently no good-quality evidence to guide treatment decisions. From this, they developed a series of proposed statements, 71 of which achieved consensus by a large group of experts in the field of bladder cancer. It is anticipated that these statements will provide further guidance to health care professionals and could help improve patient outcomes until a time when good-quality evidence is available.

Published
2020

20. EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer—An International Collaborative Multistakeholder Effort †[Formula presented] : Under the Auspices of the EAU-ESMO Guidelines Committees

Author

Witjes, J Alfred, Babjuk, Marek, Bellmunt, Joaquim, Bruins, H Maxim, De Reijke, Theo M, De Santis, Maria, Gillessen, Silke, James, Nicholas, Maclennan, Steven, Palou, Juan, Powles, Tom, Ribal, Maria J, Shariat, Shahrokh F, Der Kwast, Theo Van, Xylinas, Evanguelos, Agarwal, Neeraj, Arends, Tom, Bamias, Aristotle, Birtle, Alison, Black, Peter C, Bochner, Bernard H, Bolla, Michel, Boormans, Joost L, Bossi, Alberto, Briganti, Alberto, Brummelhuis, Iris, Burger, Max, Castellano, Daniel, Cathomas, Richard, Chiti, Arturo, Choudhury, Ananya, Compérat, Eva, Crabb, Simon, Culine, Stephane, De Bari, Berardino, De Blok, Willem, J L De Visschere, Pieter, Decaestecker, Karel, Dimitropoulos, Konstantinos, Dominguez-Escrig, Jose L, Fanti, Stefano, Fonteyne, Valerie, Frydenberg, Mark, Futterer, Jurgen J, Gakis, Georgios, Geavlete, Bogdan, Gontero, Paolo, Grubmüller, Bernhard, Hafeez, Shaista, Hansel, Donna E, Hartmann, Arndt, Hayne, Dickon, Henry, Ann M, Hernandez, Virginia, Herr, Harry, Herrmann, Ken, Hoskin, Peter, Huguet, Jorge, Jereczek-Fossa, Barbara A, Jones, Rob, Kamat, Ashish M, Khoo, Vincent, Kiltie, Anne E, Krege, Susanne, Ladoire, Sylvain, Lara, Pedro C, Leliveld, Annemarie, Linares-Espinós, Estefania, Løgager, Vibeke, Lorch, Anja, Loriot, Yohann, Meijer, Richard, Mir, M Carmen, Moschini, Marco, Mostafid, Hugh, Müller, Arndt-Christian, Müller, Christoph R, N'Dow, James, Necchi, Andrea, Neuzillet, Yann, Oddens, Jorg R, Oldenburg, Jan, Osanto, Susanne, J G Oyen, Wim, Pacheco-Figueiredo, Luís, Pappot, Helle, Patel, Manish I, Pieters, Bradley R, Plass, Karin, Remzi, Mesut, Retz, Margitta, Richenberg, Jonathan, Rink, Michael, Roghmann, Florian, Rosenberg, Jonathan E, Rouprêt, Morgan, Rouvière, Olivier, Salembier, Carl, Salminen, Antti, Sargos, Paul, Sengupta, Shomik, Sherif, Amir, Smeenk, Robert J, Smits, Anita, Stenzl, Arnulf, Thalmann, George N, Tombal, Bertrand, Turkbey, Baris, Lauridsen, Susanne Vahr, Valdagni, Riccardo, Der Heijden, Antoine G Van, Van Poppel, Hein, Vartolomei, Mihai D, Veskimäe, Erik, Vilaseca, Antoni, Rivera, Franklin A Vives, Wiegel, Thomas, Wiklund, Peter, Williams, Andrew, Zigeuner, Richard, Horwich, Alan, Witjes, J Alfred, Babjuk, Marek, Bellmunt, Joaquim, Bruins, H Maxim, De Reijke, Theo M, De Santis, Maria, Gillessen, Silke, James, Nicholas, Maclennan, Steven, Palou, Juan, Powles, Tom, Ribal, Maria J, Shariat, Shahrokh F, Der Kwast, Theo Van, Xylinas, Evanguelos, Agarwal, Neeraj, Arends, Tom, Bamias, Aristotle, Birtle, Alison, Black, Peter C, Bochner, Bernard H, Bolla, Michel, Boormans, Joost L, Bossi, Alberto, Briganti, Alberto, Brummelhuis, Iris, Burger, Max, Castellano, Daniel, Cathomas, Richard, Chiti, Arturo, Choudhury, Ananya, Compérat, Eva, Crabb, Simon, Culine, Stephane, De Bari, Berardino, De Blok, Willem, J L De Visschere, Pieter, Decaestecker, Karel, Dimitropoulos, Konstantinos, Dominguez-Escrig, Jose L, Fanti, Stefano, Fonteyne, Valerie, Frydenberg, Mark, Futterer, Jurgen J, Gakis, Georgios, Geavlete, Bogdan, Gontero, Paolo, Grubmüller, Bernhard, Hafeez, Shaista, Hansel, Donna E, Hartmann, Arndt, Hayne, Dickon, Henry, Ann M, Hernandez, Virginia, Herr, Harry, Herrmann, Ken, Hoskin, Peter, Huguet, Jorge, Jereczek-Fossa, Barbara A, Jones, Rob, Kamat, Ashish M, Khoo, Vincent, Kiltie, Anne E, Krege, Susanne, Ladoire, Sylvain, Lara, Pedro C, Leliveld, Annemarie, Linares-Espinós, Estefania, Løgager, Vibeke, Lorch, Anja, Loriot, Yohann, Meijer, Richard, Mir, M Carmen, Moschini, Marco, Mostafid, Hugh, Müller, Arndt-Christian, Müller, Christoph R, N'Dow, James, Necchi, Andrea, Neuzillet, Yann, Oddens, Jorg R, Oldenburg, Jan, Osanto, Susanne, J G Oyen, Wim, Pacheco-Figueiredo, Luís, Pappot, Helle, Patel, Manish I, Pieters, Bradley R, Plass, Karin, Remzi, Mesut, Retz, Margitta, Richenberg, Jonathan, Rink, Michael, Roghmann, Florian, Rosenberg, Jonathan E, Rouprêt, Morgan, Rouvière, Olivier, Salembier, Carl, Salminen, Antti, Sargos, Paul, Sengupta, Shomik, Sherif, Amir, Smeenk, Robert J, Smits, Anita, Stenzl, Arnulf, Thalmann, George N, Tombal, Bertrand, Turkbey, Baris, Lauridsen, Susanne Vahr, Valdagni, Riccardo, Der Heijden, Antoine G Van, Van Poppel, Hein, Vartolomei, Mihai D, Veskimäe, Erik, Vilaseca, Antoni, Rivera, Franklin A Vives, Wiegel, Thomas, Wiklund, Peter, Williams, Andrew, Zigeuner, Richard, and Horwich, Alan

Published
2020

21. Management of Patients with Advanced Prostate Cancer: Report of the Advanced Prostate Cancer Consensus Conference 2019

Author

Gillessena, Silke, Attard, Gerhardt, Beer, Tomasz M., Beltran, Himisha, Bjartell, Anders, Bossi, Alberto, Briganti, Alberto, Bristow, Rob G., Chi, Kim N., Clarke, Noel, Davis, Ian D., de Bono, Johann, Drake, Charles G., Duran, Ignacio, Eeles, Ros, Efstathiou, Eleni, Evans, Christopher P., Fanti, Stefano, Feng, Felix Y., Fizazi, Karim, Frydenberg, Mark, Gleave, Martin, Halabi, Susan, Heidenreich, Axel, Heinrich, Daniel, Higano, Celestia (Tia) S., Hofman, Michael S., Hussain, Maha, James, Nicolas, Kanesvaran, Ravindran, Kantoff, Philip, Khauli, Raja B., Leibowitz, Raya, Logothetis, Chris, Maluf, Fernando, Millman, Robin, Morgans, Alicia K., Morris, Michael J., Mottet, Nicolas, Mrabti, Hind, Murphy, Declan G., Murthy, Vedang, Oh, William K., Ost, Piet, OSullivan, Joe M., Padhani, Anwar R., Parker, Chris, Poon, Darren M. C., Pritchard, Colin C., Reiter, Robert E., Roach, Mack, Rubin, Mark, Ryan, Charles J., Saad, Fred, Sade, Juan Pablo, Sartor, Oliver, Scher, Howard, I, Shore, Neal, Small, Eric, Smith, Matthew, Soule, Howard, Sternberg, Cora N., Steuber, Thomas, Suzuki, Hiroyoshi, Sweeneyh, Christopher, Sydes, Matthew R., Taplinh, Mary-Ellen, Tombal, Bertrand, Turkeri, Levent, van Oort, Inge, Zapatero, Almudena, Omlind, Aurelius, Gillessena, Silke, Attard, Gerhardt, Beer, Tomasz M., Beltran, Himisha, Bjartell, Anders, Bossi, Alberto, Briganti, Alberto, Bristow, Rob G., Chi, Kim N., Clarke, Noel, Davis, Ian D., de Bono, Johann, Drake, Charles G., Duran, Ignacio, Eeles, Ros, Efstathiou, Eleni, Evans, Christopher P., Fanti, Stefano, Feng, Felix Y., Fizazi, Karim, Frydenberg, Mark, Gleave, Martin, Halabi, Susan, Heidenreich, Axel, Heinrich, Daniel, Higano, Celestia (Tia) S., Hofman, Michael S., Hussain, Maha, James, Nicolas, Kanesvaran, Ravindran, Kantoff, Philip, Khauli, Raja B., Leibowitz, Raya, Logothetis, Chris, Maluf, Fernando, Millman, Robin, Morgans, Alicia K., Morris, Michael J., Mottet, Nicolas, Mrabti, Hind, Murphy, Declan G., Murthy, Vedang, Oh, William K., Ost, Piet, OSullivan, Joe M., Padhani, Anwar R., Parker, Chris, Poon, Darren M. C., Pritchard, Colin C., Reiter, Robert E., Roach, Mack, Rubin, Mark, Ryan, Charles J., Saad, Fred, Sade, Juan Pablo, Sartor, Oliver, Scher, Howard, I, Shore, Neal, Small, Eric, Smith, Matthew, Soule, Howard, Sternberg, Cora N., Steuber, Thomas, Suzuki, Hiroyoshi, Sweeneyh, Christopher, Sydes, Matthew R., Taplinh, Mary-Ellen, Tombal, Bertrand, Turkeri, Levent, van Oort, Inge, Zapatero, Almudena, and Omlind, Aurelius

Abstract

Background: Innovations in treatments, imaging, and molecular characterisation in advanced prostate cancer have improved outcomes, but there are still many aspects of management that lack high-level evidence to inform clinical practice. The Advanced Prostate Cancer Consensus Conference (APCCC) 2019 addressed some of these topics to supplement guidelines that are based on level 1 evidence. Objective: To present the results from the APCCC 2019. Design, setting, and participants: Similar to prior conferences, experts identified 10 important areas of controversy regarding the management of advanced prostate cancer: locally advanced disease, biochemical recurrence after local therapy, treating the primary tumour in the metastatic setting, metastatic hormone-sensitive/naive prostate cancer, nonmetastatic castration-resistant prostate cancer, metastatic castration-resistant prostate cancer, bone health and bone metastases, molecular characterisation of tissue and blood, inter- and intrapatient heterogeneity, and adverse effects of hormonal therapy and their management. A panel of 72 international prostate cancer experts developed the programme and the consensus questions. Outcome measurements and statistical analysis: The panel voted publicly but anonymously on 123 predefined questions, which were developed by both voting and nonvoting panel members prior to the conference following a modified Delphi process. Results and limitations: Panellists voted based on their opinions rather than a standard literature review or formal meta-analysis. The answer options for the consensus questions had varying degrees of support by the panel, as reflected in this article and the detailed voting results reported in the Supplementary material. Conclusions: These voting results from a panel of prostate cancer experts can help clinicians and patients navigate controversial areas of advanced prostate management for which high-level evidence is sparse. However, diagnostic and treatment decisi

Published
2020

22. Long-term Outcomes of Salvage Lymph Node Dissection for Nodal Recurrence of Prostate Cancer After Radical Prostatectomy: Not as Good as Previously Thought

Author

Bravi, Carlo A., Fossati, Nicola, Gandaglia, Giorgio, Suardi, Nazareno, Mazzone, Elio, Robesti, Daniele, Osmonov, Daniar, Juenemann, Klaus-Peter, Boeri, Luca, Karnes, R. Jeffrey, Kretschmer, Alexander, Buchner, Alexander, Stief, Christian, Hiester, Andreas, Nini, Alessandro, Albers, Peter, Devos, Gaetan, Joniau, Steven, Van Poppel, Hendrik, Shariat, Shahrokh F., Heidenreich, Axel, Pfister, David, Tilki, Derya, Graefen, Markus, Gill, Inderbir S., Mottrie, Alexander, Karakiewicz, Pierre, I, Montorsi, Francesco, Briganti, Alberto, Bravi, Carlo A., Fossati, Nicola, Gandaglia, Giorgio, Suardi, Nazareno, Mazzone, Elio, Robesti, Daniele, Osmonov, Daniar, Juenemann, Klaus-Peter, Boeri, Luca, Karnes, R. Jeffrey, Kretschmer, Alexander, Buchner, Alexander, Stief, Christian, Hiester, Andreas, Nini, Alessandro, Albers, Peter, Devos, Gaetan, Joniau, Steven, Van Poppel, Hendrik, Shariat, Shahrokh F., Heidenreich, Axel, Pfister, David, Tilki, Derya, Graefen, Markus, Gill, Inderbir S., Mottrie, Alexander, Karakiewicz, Pierre, I, Montorsi, Francesco, and Briganti, Alberto

Abstract

Background: Long-term outcomes of patients treated with salvage lymph node dissection (sLND) for nodal recurrence of prostate cancer (PCa) remain unknown. Objective: To investigate long-term oncological outcomes after sLND in a large multiinstitutional series. Design, setting, and participants: The study included 189 patients who experienced prostate-specific antigen (PSA) rise and nodal-only recurrence after radical prostatectomy (RP) and underwent sLND at 11 tertiary referral centers between 2002 and 2011. Lymph node recurrence was documented by positron emission tomography/computed tomography (PET/CT) scan using either C-11-choline or Ga-68 prostate-specific membrane antigen ligand. Outcome measurements and statistical analysis: The primary outcome of the study was cancer-specific mortality (CSM). The secondary outcomes were overall mortality, clinical recurrence (CR), biochemical recurrence (BCR), and androgen deprivation therapy (ADT)-free survival after sLND. The probability of freedom from each outcome was calculated using Kaplan-Meier analyses. Cox regression analysis was used to predict the risk of prostate CSM after accounting for several parameters, including the use of additional treatments after sLND. Results and limitations: At long term, 110 and 163 patients experienced CR and BCR, respectively, with CR-free and BCR-free survival at 10 yr of 31% and 11%, respectively. After sLND, a total of 145 patients received ADT, with a median time to ADT of 41 mo. At a median (interquartile range) follow-up for survivors of 87 (51, 104) mo, 48 patients died. Of them, 45 died from PCa. The probabilities of freedom from cancer-specific and all-cause death at 10 yr were 66% and 64%, respectively. Similar results were obtained in sensitivity analyses in patients with pelvic-only positive PET/CT scan, as well as after excluding men on ADT at PET/CT scan and patients with PSA level at sLND higher than the 75th percentile. At multivariable analyses, patients who had PSA

Published
2020

23. Assessing the Best Surgical Template at Salvage Pelvic Lymph Node Dissection for Nodal Recurrence of Prostate Cancer After Radical Prostatectomy: When Can Bilateral Dissection be Omitted? Results from a Multi-institutional Series

Author

Bravi, Carlo A., Fossati, Nicola, Gandaglia, Giorgio, Suardi, Nazareno, Mazzone, Elio, Robesti, Daniele, Osmonov, Daniar, Juenemann, Klaus-Peter, Boeri, Luca, Karnes, R. Jeffrey, Kretschmer, Alexander, Buchner, Alexander, Stief, Christian, Hiester, Andreas, Nini, Alessandro, Albers, Peter, Devos, Gaetan, Joniau, Steven, Van Poppel, Hendrik, Shariat, Shahrokh F., Heidenreich, Axel, Pfister, David, Tilki, Derya, Graefen, Markus, Gill, Inderbir S., Mottrie, Alexander, Karakiewicz, Pierre, I, Montorsi, Francesco, Briganti, Alberto, Bravi, Carlo A., Fossati, Nicola, Gandaglia, Giorgio, Suardi, Nazareno, Mazzone, Elio, Robesti, Daniele, Osmonov, Daniar, Juenemann, Klaus-Peter, Boeri, Luca, Karnes, R. Jeffrey, Kretschmer, Alexander, Buchner, Alexander, Stief, Christian, Hiester, Andreas, Nini, Alessandro, Albers, Peter, Devos, Gaetan, Joniau, Steven, Van Poppel, Hendrik, Shariat, Shahrokh F., Heidenreich, Axel, Pfister, David, Tilki, Derya, Graefen, Markus, Gill, Inderbir S., Mottrie, Alexander, Karakiewicz, Pierre, I, Montorsi, Francesco, and Briganti, Alberto

Abstract

The best surgical template for salvage pelvic lymph node dissection (sLND) in patients with nodal recurrence from prostate cancer (PCa) after radical prostatectomy (RP) is currently unknown. We analyzed data of 189 patients with a unilateral positive positron emission tomography (PET) scan of the pelvic lymph node areas, who were treated with bilateral pelvic sLND after RP at 11 high-volume centers. The primary endpoint was missed contralateral disease at final pathology, defined as lymph node positive for PCa in the side opposite to the positive spot(s) at the PET scan. Overall, 93 (49%) and 96 (51%) patients received a C-11-choline and a Ga-68 prostate-specific membrane antigen (PSMA) PET scan, respectively, and 171 (90%) and 18 (10%) men had one and two positive spots, respectively. The rate of missed contralateral PCa was 18% (34/189), with the rates being 17% (29/171) and 28% (5/18) in men with one and two positive spots, respectively. While the rate of contralateral disease did not differ between Ga-68-PSMA and C-11-choline (29% and 27%, respectively) among men with two positive spots, the rate of contralateral PCa was only 6% with Ga-68-PSMA versus 28% with C-11-choline in patients with a single positive spot. This finding was confirmed at multivariable logistic regression analysis predicting missed disease at final pathology after accounting for confounders (odds ratio: 0.24; p = 0.001). However, in men with a single positive spot at Ga-68-PSMA PET/computed tomography, the rate of single confirmed lymph node metastasis at final pathology was only 33%, suggesting the need for extended template even if unilateral dissection is performed. Awaiting confirmatory studies, patients diagnosed with a single positive spot at the Ga-68-PSMA PET scan might be considered for unilateral extended pelvic sLND. Patient summary: We assessed the risk of missing contralateral disease in patients with a positron emission tomography (PET) scan suggestive of unilateral nodal recur

Published
2020

24. EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer—An International Collaborative Multistakeholder Effort †[Formula presented]: Under the Auspices of the EAU-ESMO Guidelines Committees

Author

MS Urologische Oncologie, Cancer, Urologie Medisch volwassenen, Witjes, J Alfred, Babjuk, Marek, Bellmunt, Joaquim, Bruins, H Maxim, De Reijke, Theo M, De Santis, Maria, Gillessen, Silke, James, Nicholas, Maclennan, Steven, Palou, Juan, Powles, Tom, Ribal, Maria J, Shariat, Shahrokh F, Der Kwast, Theo Van, Xylinas, Evanguelos, Agarwal, Neeraj, Arends, Tom, Bamias, Aristotle, Birtle, Alison, Black, Peter C, Bochner, Bernard H, Bolla, Michel, Boormans, Joost L, Bossi, Alberto, Briganti, Alberto, Brummelhuis, Iris, Burger, Max, Castellano, Daniel, Cathomas, Richard, Chiti, Arturo, Choudhury, Ananya, Compérat, Eva, Crabb, Simon, Culine, Stephane, De Bari, Berardino, De Blok, Willem, J L De Visschere, Pieter, Decaestecker, Karel, Dimitropoulos, Konstantinos, Dominguez-Escrig, Jose L, Fanti, Stefano, Fonteyne, Valerie, Frydenberg, Mark, Futterer, Jurgen J, Gakis, Georgios, Geavlete, Bogdan, Gontero, Paolo, Grubmüller, Bernhard, Hafeez, Shaista, Hansel, Donna E, Hartmann, Arndt, Hayne, Dickon, Henry, Ann M, Hernandez, Virginia, Herr, Harry, Herrmann, Ken, Hoskin, Peter, Huguet, Jorge, Jereczek-Fossa, Barbara A, Jones, Rob, Kamat, Ashish M, Khoo, Vincent, Kiltie, Anne E, Krege, Susanne, Ladoire, Sylvain, Lara, Pedro C, Leliveld, Annemarie, Linares-Espinós, Estefania, Løgager, Vibeke, Lorch, Anja, Loriot, Yohann, Meijer, Richard, Mir, M Carmen, Moschini, Marco, Mostafid, Hugh, Müller, Arndt-Christian, Müller, Christoph R, N'Dow, James, Necchi, Andrea, Neuzillet, Yann, Oddens, Jorg R, Oldenburg, Jan, Osanto, Susanne, J G Oyen, Wim, Pacheco-Figueiredo, Luís, Pappot, Helle, Patel, Manish I, Pieters, Bradley R, Plass, Karin, Remzi, Mesut, Retz, Margitta, Richenberg, Jonathan, Rink, Michael, Roghmann, Florian, Rosenberg, Jonathan E, Rouprêt, Morgan, Rouvière, Olivier, Salembier, Carl, Salminen, Antti, Sargos, Paul, Sengupta, Shomik, Sherif, Amir, Smeenk, Robert J, Smits, Anita, Stenzl, Arnulf, Thalmann, George N, Tombal, Bertrand, Turkbey, Baris, Lauridsen, Susanne Vahr, Valdagni, Riccardo, Der Heijden, Antoine G Van, Van Poppel, Hein, Vartolomei, Mihai D, Veskimäe, Erik, Vilaseca, Antoni, Rivera, Franklin A Vives, Wiegel, Thomas, Wiklund, Peter, Williams, Andrew, Zigeuner, Richard, Horwich, Alan, MS Urologische Oncologie, Cancer, Urologie Medisch volwassenen, Witjes, J Alfred, Babjuk, Marek, Bellmunt, Joaquim, Bruins, H Maxim, De Reijke, Theo M, De Santis, Maria, Gillessen, Silke, James, Nicholas, Maclennan, Steven, Palou, Juan, Powles, Tom, Ribal, Maria J, Shariat, Shahrokh F, Der Kwast, Theo Van, Xylinas, Evanguelos, Agarwal, Neeraj, Arends, Tom, Bamias, Aristotle, Birtle, Alison, Black, Peter C, Bochner, Bernard H, Bolla, Michel, Boormans, Joost L, Bossi, Alberto, Briganti, Alberto, Brummelhuis, Iris, Burger, Max, Castellano, Daniel, Cathomas, Richard, Chiti, Arturo, Choudhury, Ananya, Compérat, Eva, Crabb, Simon, Culine, Stephane, De Bari, Berardino, De Blok, Willem, J L De Visschere, Pieter, Decaestecker, Karel, Dimitropoulos, Konstantinos, Dominguez-Escrig, Jose L, Fanti, Stefano, Fonteyne, Valerie, Frydenberg, Mark, Futterer, Jurgen J, Gakis, Georgios, Geavlete, Bogdan, Gontero, Paolo, Grubmüller, Bernhard, Hafeez, Shaista, Hansel, Donna E, Hartmann, Arndt, Hayne, Dickon, Henry, Ann M, Hernandez, Virginia, Herr, Harry, Herrmann, Ken, Hoskin, Peter, Huguet, Jorge, Jereczek-Fossa, Barbara A, Jones, Rob, Kamat, Ashish M, Khoo, Vincent, Kiltie, Anne E, Krege, Susanne, Ladoire, Sylvain, Lara, Pedro C, Leliveld, Annemarie, Linares-Espinós, Estefania, Løgager, Vibeke, Lorch, Anja, Loriot, Yohann, Meijer, Richard, Mir, M Carmen, Moschini, Marco, Mostafid, Hugh, Müller, Arndt-Christian, Müller, Christoph R, N'Dow, James, Necchi, Andrea, Neuzillet, Yann, Oddens, Jorg R, Oldenburg, Jan, Osanto, Susanne, J G Oyen, Wim, Pacheco-Figueiredo, Luís, Pappot, Helle, Patel, Manish I, Pieters, Bradley R, Plass, Karin, Remzi, Mesut, Retz, Margitta, Richenberg, Jonathan, Rink, Michael, Roghmann, Florian, Rosenberg, Jonathan E, Rouprêt, Morgan, Rouvière, Olivier, Salembier, Carl, Salminen, Antti, Sargos, Paul, Sengupta, Shomik, Sherif, Amir, Smeenk, Robert J, Smits, Anita, Stenzl, Arnulf, Thalmann, George N, Tombal, Bertrand, Turkbey, Baris, Lauridsen, Susanne Vahr, Valdagni, Riccardo, Der Heijden, Antoine G Van, Van Poppel, Hein, Vartolomei, Mihai D, Veskimäe, Erik, Vilaseca, Antoni, Rivera, Franklin A Vives, Wiegel, Thomas, Wiklund, Peter, Williams, Andrew, Zigeuner, Richard, and Horwich, Alan

Published
2020

25. 68 Ga-PSMA-11 PET Detects Residual Prostate Cancer after Prostatectomy in a Multicenter Retrospective Study

Author

Farolfi, Andrea, Gafita, Andrei, Calais, Jeremie, Eiber, Matthias, Afshar-Oromieh, Ali, Spohn, Fabian, Barbato, Francesco, Weber, Manuel, Ilhan, Harun, Cervati, Veronica, Wetter, Axel, Hadaschik, Boris, Briganti, Alberto, Walz, Jochen, Pianori, Davide, Fanti, Stefano, Haberkorn, Uwe, Herrmann, Ken, and Fendler, Wolfgang Peter

Subjects
urologic and male genital diseases, 610 Medicine & health
Abstract

PURPOSE: PSA persistence after radical prostatectomy is associated with adverse outcome in patients with prostate cancer. We aimed to define regions at risk for residual disease as well as the accuracy of PSMA-ligand PET in patients with PSA persistence. MATERIALS AND METHODS: From 6 participating centers, 191 patients with 68Ga-PSMA-11 PET scan (PET/CT or PET/MRI) for persistently elevated post-operative PSA levels (≥0.1 ng/mL) were retrospectively included. Detection rate and positive-predictive value were determined. In patients with additional PSMA-ligand PET before prostatectomy (n=33), rate of PET-based persistence and recurrence was determined. RESULTS: PSMA-ligand PET localized PCa-lesions in 68% (130 of 191) patients with PSA persistence at a median PSA level of 1.1 ng/mL. Detection rate significantly increased with the PSA (p

Published
2019
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26. EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer from an International Collaborative Study (DETECTIVE Study)

Author

Lam, Thomas B L, MacLennan, Steven, Willemse, Peter-Paul M, Mason, Malcolm D, Plass, Karin, Shepherd, Robert, Baanders, Ruud, Bangma, Chris H, Bjartell, Anders, Bossi, Alberto, Briers, Erik, Briganti, Alberto, Buddingh, Karel T, Catto, James W F, Colecchia, Maurizio, Cox, Brett W, Cumberbatch, Marcus G, Davies, Jeff, Davis, Niall F, De Santis, Maria, Dell'Oglio, Paolo, Deschamps, André, Donaldson, James F, Egawa, Shin, Fankhauser, Christian D, Fanti, Stefano, Fossati, Nicola, Gandaglia, Giorgio, Gillessen, Silke, Grivas, Nikolaos, Gross, Tobias, Grummet, Jeremy P, Henry, Ann M, Ingels, Alexandre, Irani, Jacques, Lardas, Michael, Liew, Matthew, Lin, Daniel W, Moris, Lisa, Omar, Muhammad Imran, Pang, Karl H, Paterson, Catherine C, Renard-Penna, Raphaële, Ribal, Maria J, Roobol, Monique J, Rouprêt, Morgan, Rouvière, Olivier, Sancho Pardo, Gemma, Richenberg, Jonathan, Schoots, Ivo G, Sedelaar, J P Michiel, Stricker, Phillip, Tilki, Derya, Vahr Lauridsen, Susanne, van den Bergh, Roderick C N, Van den Broeck, Thomas, van der Kwast, Theodorus H, van der Poel, Henk G, van Leenders, Geert J L H, Varma, Murali, Violette, Philippe D, Wallis, Christopher J D, Wiegel, Thomas, Wilkinson, Karen, Zattoni, Fabio, N'Dow, James M O, Van Poppel, Hendrik, Cornford, Philip, Mottet, Nicolas, Lam, Thomas B L, MacLennan, Steven, Willemse, Peter-Paul M, Mason, Malcolm D, Plass, Karin, Shepherd, Robert, Baanders, Ruud, Bangma, Chris H, Bjartell, Anders, Bossi, Alberto, Briers, Erik, Briganti, Alberto, Buddingh, Karel T, Catto, James W F, Colecchia, Maurizio, Cox, Brett W, Cumberbatch, Marcus G, Davies, Jeff, Davis, Niall F, De Santis, Maria, Dell'Oglio, Paolo, Deschamps, André, Donaldson, James F, Egawa, Shin, Fankhauser, Christian D, Fanti, Stefano, Fossati, Nicola, Gandaglia, Giorgio, Gillessen, Silke, Grivas, Nikolaos, Gross, Tobias, Grummet, Jeremy P, Henry, Ann M, Ingels, Alexandre, Irani, Jacques, Lardas, Michael, Liew, Matthew, Lin, Daniel W, Moris, Lisa, Omar, Muhammad Imran, Pang, Karl H, Paterson, Catherine C, Renard-Penna, Raphaële, Ribal, Maria J, Roobol, Monique J, Rouprêt, Morgan, Rouvière, Olivier, Sancho Pardo, Gemma, Richenberg, Jonathan, Schoots, Ivo G, Sedelaar, J P Michiel, Stricker, Phillip, Tilki, Derya, Vahr Lauridsen, Susanne, van den Bergh, Roderick C N, Van den Broeck, Thomas, van der Kwast, Theodorus H, van der Poel, Henk G, van Leenders, Geert J L H, Varma, Murali, Violette, Philippe D, Wallis, Christopher J D, Wiegel, Thomas, Wilkinson, Karen, Zattoni, Fabio, N'Dow, James M O, Van Poppel, Hendrik, Cornford, Philip, and Mottet, Nicolas

Published
2019

27. EAU-EANM-ESTRO-ESUR-SIOG Prostate Cancer Guideline Panel Consensus Statements for Deferred Treatment with Curative Intent for Localised Prostate Cancer from an International Collaborative Study (DETECTIVE Study)

Author

MS Urologische Oncologie, Lam, Thomas B L, MacLennan, Steven, Willemse, Peter-Paul M, Mason, Malcolm D, Plass, Karin, Shepherd, Robert, Baanders, Ruud, Bangma, Chris H, Bjartell, Anders, Bossi, Alberto, Briers, Erik, Briganti, Alberto, Buddingh, Karel T, Catto, James W F, Colecchia, Maurizio, Cox, Brett W, Cumberbatch, Marcus G, Davies, Jeff, Davis, Niall F, De Santis, Maria, Dell'Oglio, Paolo, Deschamps, André, Donaldson, James F, Egawa, Shin, Fankhauser, Christian D, Fanti, Stefano, Fossati, Nicola, Gandaglia, Giorgio, Gillessen, Silke, Grivas, Nikolaos, Gross, Tobias, Grummet, Jeremy P, Henry, Ann M, Ingels, Alexandre, Irani, Jacques, Lardas, Michael, Liew, Matthew, Lin, Daniel W, Moris, Lisa, Omar, Muhammad Imran, Pang, Karl H, Paterson, Catherine C, Renard-Penna, Raphaële, Ribal, Maria J, Roobol, Monique J, Rouprêt, Morgan, Rouvière, Olivier, Sancho Pardo, Gemma, Richenberg, Jonathan, Schoots, Ivo G, Sedelaar, J P Michiel, Stricker, Phillip, Tilki, Derya, Vahr Lauridsen, Susanne, van den Bergh, Roderick C N, Van den Broeck, Thomas, van der Kwast, Theodorus H, van der Poel, Henk G, van Leenders, Geert J L H, Varma, Murali, Violette, Philippe D, Wallis, Christopher J D, Wiegel, Thomas, Wilkinson, Karen, Zattoni, Fabio, N'Dow, James M O, Van Poppel, Hendrik, Cornford, Philip, Mottet, Nicolas, MS Urologische Oncologie, Lam, Thomas B L, MacLennan, Steven, Willemse, Peter-Paul M, Mason, Malcolm D, Plass, Karin, Shepherd, Robert, Baanders, Ruud, Bangma, Chris H, Bjartell, Anders, Bossi, Alberto, Briers, Erik, Briganti, Alberto, Buddingh, Karel T, Catto, James W F, Colecchia, Maurizio, Cox, Brett W, Cumberbatch, Marcus G, Davies, Jeff, Davis, Niall F, De Santis, Maria, Dell'Oglio, Paolo, Deschamps, André, Donaldson, James F, Egawa, Shin, Fankhauser, Christian D, Fanti, Stefano, Fossati, Nicola, Gandaglia, Giorgio, Gillessen, Silke, Grivas, Nikolaos, Gross, Tobias, Grummet, Jeremy P, Henry, Ann M, Ingels, Alexandre, Irani, Jacques, Lardas, Michael, Liew, Matthew, Lin, Daniel W, Moris, Lisa, Omar, Muhammad Imran, Pang, Karl H, Paterson, Catherine C, Renard-Penna, Raphaële, Ribal, Maria J, Roobol, Monique J, Rouprêt, Morgan, Rouvière, Olivier, Sancho Pardo, Gemma, Richenberg, Jonathan, Schoots, Ivo G, Sedelaar, J P Michiel, Stricker, Phillip, Tilki, Derya, Vahr Lauridsen, Susanne, van den Bergh, Roderick C N, Van den Broeck, Thomas, van der Kwast, Theodorus H, van der Poel, Henk G, van Leenders, Geert J L H, Varma, Murali, Violette, Philippe D, Wallis, Christopher J D, Wiegel, Thomas, Wilkinson, Karen, Zattoni, Fabio, N'Dow, James M O, Van Poppel, Hendrik, Cornford, Philip, and Mottet, Nicolas

Published
2019

28. Silodosin and tadalafil have synergistic inhibitory effects on nerve-mediated contractions of human and rat isolated prostates

Author

Buono, Roberta, Briganti, Alberto, Freschi, Massimo, Villa, Luca, La Croce, Giovanni, Moschini, Marco, Benigni, Fabio, Castiglione, Fabio, Montorsi, Francesco, Hedlund, Petter, Buono, Roberta, Briganti, Alberto, Freschi, Massimo, Villa, Luca, La Croce, Giovanni, Moschini, Marco, Benigni, Fabio, Castiglione, Fabio, Montorsi, Francesco, and Hedlund, Petter

Abstract

Lower urinary tract symptoms (CUTS) in men with benign prostatic hyperplasia (BPH) are associated with erectile dysfunction. Alpha-1-adrenoceptor antagonists are effective drugs for treating symptomatic BPH. Clinical data show improvements in LUIS by phosphodiesterase 5 inhibitors. This study aimed to evaluate effects of siloclosin, a highly selective alpha(1A)-adrenoceptor antagonist, alone or in combination with the phosphocliesterase 5 inhibitor tadalafil on contractions of isolated human and rat prostates. In organbath studies, effects of increasing concentrations of siloclosin (1 nM-1 mu M) and tadalafil (100 nM-100 mu M) on contractions by electrical field stimulation or phenylephrine of human and rat prostate strip preparations were investigated. The combination silodosin and tadalafil reduced electrically-induced contractions of human prostate preparations better than single drugs alone. At any frequencies (1-32 Hz), inhibitory effects of combined therapy (P-values vs single drug) in human tissue were 26-42% (1 nM silodosin+100 nM tadalafil; P less than 0.05), 40-58% (10 nM silodosin+1 mu M tadalafil; P less than 0.001-0.05), 56-67% (100 nM silodosin+10 mu M tadalafil; P less than 0.01-0.05), and 33-55% (1 mu M silodosin+100 mu M tadalafil P less than 0.01-0.05), Similar findings were obtained in rat prostate preparations. In human and rat prostate tissue, the drug combination exerted similar inhibitory effect on phenylephrine contractions as silodosin alone. Silodosin plus tadalafil had greater potency than each drug alone to inhibit prostate contractions to electrical field stimulation but not to phenylephrine. This study supports the clinical application of a combination of an (alpha(1A)-adrenoceptor antagonist and a phosphodiesterase 5 inhibitor for symptomatic BPH and suggests that the drug combination requires endogenous nerve-activity for optimal effect., Funding Agencies|Urological Research Institute; Gester Foundation; Recordati

Published
2014
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29. Corrigendum to 'EAU-ESMO Consensus Statements on the Management of Advanced and Variant Bladder Cancer-An International Collaborative Multistakeholder Effort Under the Auspices of the EAU-ESMO Guidelines Committees' [European Urology 77 (2020) 223-250]

Author

Witjes, J Alfred, Babjuk, Marek, Bellmunt, Joaquim, Bruins, H Maxim, De Reijke, Theo M, De Santis, Maria, Gillessen, Silke, James, Nicholas, Maclennan, Steven, Palou, Juan, Powles, Tom, Ribal, Maria J, Shariat, Shahrokh F, Van Der Kwast, Theo, Xylinas, Evanguelos, Agarwal, Neeraj, Arends, Tom, Bamias, Aristotle, Birtle, Alison, Black, Peter C, Bochner, Bernard H, Bolla, Michel, Boormans, Joost L, Bossi, Alberto, Briganti, Alberto, Brummelhuis, Iris, Burger, Max, Castellano, Daniel, Cathomas, Richard, Chiti, Arturo, Choudhury, Ananya, Compérat, Eva, Crabb, Simon, Culine, Stephane, De Bari, Berardino, De Blok, Willem, De Visschere, Pieter J L, Decaestecker, Karel, Dimitropoulos, Konstantinos, Dominguez-Escrig, Jose L, Fanti, Stefano, Fonteyne, Valerie, Frydenberg, Mark, Futterer, Jurgen J, Gakis, Georgios, Geavlete, Bogdan, Gontero, Paolo, Grubmüller, Bernhard, Hafeez, Shaista, Hansel, Donna E, Hartmann, Arndt, Hayne, Dickon, Henry, Ann M, Hernandez, Virginia, Herr, Harry, Herrmann, Ken, Hoskin, Peter, Huguet, Jorge, Jereczek-Fossa, Barbara A, Jones, Rob, Kamat, Ashish M, Khoo, Vincent, Kiltie, Anne E, Krege, Susanne, Ladoire, Sylvain, Lara, Pedro C, Leliveld, Annemarie, Linares-Espinós, Estefania, Løgager, Vibeke, Lorch, Anja, Loriot, Yohann, Meijer, Richard, Mir, M Carmen, Moschini, Marco, Mostafid, Hugh, Müller, Arndt-Christian, Müller, Christoph R, N'Dow, James, Necchi, Andrea, Neuzillet, Yann, Oddens, Jorg R, Oldenburg, Jan, Osanto, Susanne, Oyen, Wim J G, Pacheco-Figueiredo, Luís, Pappot, Helle, Patel, Manish I, Pieters, Bradley R, Plass, Karin, Remzi, Mesut, Retz, Margitta, Richenberg, Jonathan, Rink, Michael, Roghmann, Florian, Rosenberg, Jonathan E, Rouprêt, Morgan, Rouvière, Olivier, Salembier, Carl, Salminen, Antti, Sargos, Paul, Sengupta, Shomik, Sherif, Amir, Smeenk, Robert J, Smits, Anita, Stenzl, Arnulf, Thalmann, George N., Tombal, Bertrand, Turkbey, Baris, Lauridsen, Susanne Vahr, Valdagni, Riccardo, Van Der Heijden, Antoine G, Van Poppel, Hein, Vartolomei, Mihai D, Veskimäe, Erik, Vilaseca, Antoni, Rivera, Franklin A Vives, Wiegel, Thomas, Wiklund, Peter, Willemse, Peter-Paul M, Williams, Andrew, Zigeuner, Richard, and Horwich, Alan

Subjects
610 Medicine & health, 3. Good health

30. Identifying the Optimal Candidate for Salvage Lymph Node Dissection for Nodal Recurrence of Prostate Cancer: Results from a Large, Multi-institutional Analysis

Author

Alessandro Larcher, Hendrik Van Poppel, Nicola Fossati, Shahrokh F. Shariat, Almut Kalz, Annika Herlemann, Christian Gratzke, Daniar Osmonov, Francesco Montorsi, Nieroshan Rajarubendra, Alexander Mottrie, Nazareno Suardi, Inderbir S. Gill, Klaus P. Juenemann, R. Jeffrey Karnes, Steven Joniau, Maximilian Schmautz, A. Battaglia, Axel Heidenreich, Alberto Briganti, Giorgio Gandaglia, Carlo Andrea Bravi, Wouter Everaerts, Christian Stief, Matteo Soligo, Fossati, Nicola, Suardi, Nazareno, Gandaglia, Giorgio, Bravi, Carlo A., Soligo, Matteo, Karnes, R. Jeffrey, Shariat, Shahrokh, Battaglia, Antonino, Everaerts, Wouter, Joniau, Steven, Van Poppel, Hendrik, Rajarubendra, Nieroshan, Gill, Inderbir S., Larcher, Alessandro, Mottrie, Alexander, Schmautz, Maximilian, Heidenreich, Axel, Kalz, Almut, Osmonov, Daniar, Juenemann, Klaus-Peter, Herlemann, Annika, Gratzke, Christian, Stief, Christian, Montorsi, Francesco, and Briganti, Alberto

Subjects
Male, IMPACT, medicine.medical_treatment, 030232 urology & nephrology, Salvage therapy, Prostate cancer, PSA, Neoplasm Recurrence, 0302 clinical medicine, Interquartile range, Medicine, BIOCHEMICAL RECURRENCE, ADJUVANT RADIOTHERAPY, Lymph node, medicine.diagnostic_test, Prostatectomy, SITE, Middle Aged, Urology & Nephrology, Dissection, medicine.anatomical_structure, Local, Positron emission tomography, 030220 oncology & carcinogenesis, Lymph node excision, Neoplasm recurrence, Positron emission tomography computed tomography, Prostatic neoplasms, Aged, Humans, Prostatic Neoplasms, Risk Assessment, Salvage Therapy, Lymph Node Excision, SURVIVAL, Radiology, Life Sciences & Biomedicine, medicine.medical_specialty, PET/CT, Urology, MEDLINE, Article, 03 medical and health sciences, Neoplasm Recurrence, Local, Science & Technology, business.industry, Proportional hazards model, medicine.disease, NODAL, Prostatic neoplasm, business
Abstract

Background: Salvage lymph node dissection (SLND) represents a possible treatment option for prostate cancer patients affected by nodal recurrence after local treatment. However, SLND may be associated with intra- and postoperative complications, and the oncological benefit may be limited to specific groups of patients. Objective: To identify the optimal candidates for SLND based on preoperative characteristics. Design, setting, and participants: The study included 654 patients who experienced prostate-specific antigen (PSA) rise and nodal recurrence after radical prostatectomy (RP) and underwent SLND at nine tertiary referral centers. Lymph node recurrence was documented by positron emission tomography/computed tomography (PET/CT) scan using either 11C-choline or 68Ga-labeled prostate-specific membrane antigen ligand. Intervention: SLND. Outcome measurements and statistical analysis: The study outcome was early clinical recurrence (eCR) developed within 1 yr after SLND. Multivariable Cox regression analysis was used to develop a predictive model. Multivariable-derived coefficients were used to develop a novel risk calculator. Decision-curve analysis was used to evaluate the net benefit of the predictive model. Results and limitations: Median follow-up was 30 (interquartile range, 16–50) mo among patients without clinical recurrence (CR), and 334 patients developed CR after SLND. In particular, eCR at 1 yr after SLND was observed in 150 patients, with a Kaplan-Meier probability of eCR equal to 25%. The development of eCR was significantly associated with an increased risk of cancer-specific mortality at 3 yr, being 20% versus 1.4% in patients with and without eCR, respectively (p < 0.0001). At multivariable analysis, Gleason grade group 5 (hazard ratio [HR]: 2.04; p < 0.0001), time from RP to PSA rising (HR: 0.99; p = 0.025), hormonal therapy administration at PSA rising after RP (HR: 1.47; p = 0.0005), retroperitoneal uptake at PET/CT scan (HR: 1.24; p = 0.038), three or more positive spots at PET/CT scan (HR: 1.26; p = 0.019), and PSA level at SLND (HR: 1.05; p < 0.0001) were significant predictors of CR after SLND. The coefficients of the predictive model were used to develop a risk calculator for eCR at 1 yr after SLND. The discrimination of the model (Harrel's C index) was 0.75. At decision-curve analysis, the net benefit of the model was higher than the “treat-all” option at all the threshold probabilities. Conclusions: We reported the largest available series of patients treated with SLND. Roughly 25% of men developed eCR after surgery. We developed the first risk stratification tool to identify the optimal candidate to SLND based on routinely available preoperative characteristics. This tool can be useful to avoid use of SLND in men more likely to progress despite any imaging-guided approach. Patient summary: The risk of early recurrence after salvage lymph node dissection (SLND) was approximately 25%. In this study, we developed a novel tool to predict the risk of early failure after SLND. This tool will be useful to identify patients who would benefit the most from SLND from other patients who should be spared from surgery. We reported the largest available series of patients treated with salvage lymph node dissection (SLND), and we developed the first risk stratification tool to identify the optimal candidate to SLND based on routinely available preoperative characteristics. This tool can be useful to avoid use of SLND in men more likely to progress despite any imaging-guided approach.

Published
2019

31. Active Surveillance for Prostate Cancer: A Systematic Review of Clinicopathologic Variables and Biomarkers for Risk Stratification

Author

Alberto Briganti, Yoshiyuki Kakehi, Joseph Nicholson, Stacy Loeb, Sophie Bruinsma, Tom Pickles, Sigrid Carlsson, Monique J. Roobol, Urology, Loeb, Stacy, Bruinsma, Sophie M., Nicholson, Joseph, Briganti, Alberto, Pickles, Tom, Kakehi, Yoshiyuki, Carlsson, Sigrid V., and Roobol, Monique J.

Subjects
PCA3, Oncology, Male, medicine.medical_specialty, Urology, Biopsy, Context (language use), Active surveillance, TMPRSS2, Nomogram, Article, Prostate cancer, PSA, SDG 3 - Good Health and Well-being, Prostate, Antigens, Neoplasm, Risk Factors, Internal medicine, medicine, Humans, Oncogene Fusion, Genetic marker, Risk stratification, Gynecology, medicine.diagnostic_test, business.industry, Risk Factor, Serine Endopeptidases, Cancer, Prostatic Neoplasms, Prostate-Specific Antigen, medicine.disease, Treatment, Serine Endopeptidase, medicine.anatomical_structure, Population Surveillance, Prostatic Neoplasm, Disease Progression, business, Human
Abstract

Context: Active surveillance (AS) is an important strategy to reduce prostate cancer overtreatment. However, the optimal criteria for eligibility and predictors of progression while on AS are debated. Objective: To review primary data on markers, genetic factors, and risk stratification for patient selection and predictors of progression during AS. Evidence acquisition: Electronic searches were conducted in PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to April 2014 for original articles on biomarkers and risk stratification for AS. Evidence synthesis: Patient factors associated with AS outcomes in some studies include age, race, and family history. Multiple studies provide consistent evidence that a lower percentage of free prostate-specific antigen (PSA), a higher Prostate Health Index (PHI), a higher PSA density (PSAD), and greater biopsy core involvement at baseline predict a greater risk of progression. During follow-up, serial measurements of PHI and PSAD, as well as repeat biopsy results, predict later biopsy progression. While some studies have suggested a univariate relationship between urinary prostate cancer antigen 3 (PCA3) and transmembrane protease, serine 2-v-ets avian erythroblastosis virus E26 oncogene homolog gene fusion (TMPRSS2:ERG) with adverse biopsy features, these markers have not been consistently shown to independently predict AS outcomes. No conclusive data support the use of genetic tests in AS. Limitations of these studies include heterogeneous definitions of progression and limited follow-up. Conclusions: There is a growing body of literature on patient characteristics, biopsy features, and biomarkers with potential utility in AS. More data are needed on practical applications such as combining these tests into multivariable clinical algorithms and long-term outcomes to further improve AS in the future. Patient summary: Several PSA-based tests (free PSA, PHI, PSAD) and the extent of cancer on biopsy can help to stratify the risk of progression during active surveillance. Investigation of several other markers is under way. (C) 2014 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Published
2015

32. Re: Alessandro Volpe, Kamran Ahmed, Prokar Dasgupta, et al. Pilot Validation Study of the European Association of Urology Robotic Training Curriculum. Eur Urol 2015;68:292-9

Author

Marco Oderda, Rodolfo Sanchez-Salas, Alberto Briganti, Remi Navarro, Martin Janssen, Matthew A. Brown, François Audenet, Esther Wit, Melanie Gan, Vincenzo De Marco, Oderda, Marco, Audenet, Francoi, Briganti, Alberto, Brown, Matthew, De Marco, Vincenzo, Gan, Melanie, Janssen, Martin, Navarro, Remi, Sanchez Salas, Rodolfo, and Wit, Esther

Subjects
medicine.medical_specialty, Validation study, Robotic Surgical Procedure, medicine.medical_treatment, Urology, Education, Robotic Surgical Procedures, Medical, Medicine, Animals, Humans, Graduate, Societies, Medical, Training curriculum, Prostatectomy, business.industry, Animal, Medicine (all), Teaching, Education, Medical, Graduate, business, Societies, Human
Published
2015

33. Re: Mark K. Buyyounouski. Radiobiological modeling and the study of hypofractionated radiotherapy for prostate cancer. Eur Urol 2014;66:1031-2

Author

Alberto Briganti, Claudio Fiorino, Cesare Cozzarini, Fiorino, Claudio, Briganti, Alberto, and Cozzarini, Cesare

Subjects
Hypofractionated Radiotherapy, Urologic Diseases, Male, medicine.medical_specialty, Urology, Urinary Bladder, Salvage therapy, Prostate cancer, Urethra, medicine, Humans, Urologic Disease, Radiation Injuries, Radiation Injurie, Dose Fractionation, Salvage Therapy, Urinary bladder, business.industry, Dose fractionation, Prostatic Neoplasms, medicine.disease, medicine.anatomical_structure, Prostatic Neoplasm, Urologic disease, Dose Fractionation, Radiation, business, Human
Published
2015

34. Stratification of high-risk prostate cancer into prognostic categories: A european multi-institutional study

Author

Joniau, S, Briganti, A, Gontero, Paolo, Gandaglia, G, Tosco, L, Fieuws, S, Tombal, B, Marchioro, G, Walz, J, Kneitz, B, Bader, P, Frohneberg, D, Tizzani, A, Graefen, M, van Cangh, P, Karnes, Rj, Montorsi, F, Van Poppel, H, Spahn, M, European Multicenter Prostate Cancer Clinical, Translational Research Group, Joniau, Steven, Briganti, Alberto, Gontero, Paolo, Gandaglia, Giorgio, Tosco, Lorenzo, Fieuws, Steffen, Tombal, Bertrand, Marchioro, Giansilvio, Walz, Jochen, Kneitz, Burkhard, Bader, Pia, Frohneberg, Detlef, Tizzani, Alessandro, Graefen, Marku, van Cangh, Paul, Karnes R., Jeffrey, Montorsi, Francesco, Van Poppel, Hein, and Spahn, Martin

Subjects
Oncology, High-risk prostate cancer, Male, medicine.medical_specialty, Urology, Predictive Value of Test, Disease, Risk Assessment, Stratification (mathematics), Disease-Free Survival, Prostate cancer, Locally advanced prostate cancer, Risk groups, Predictive Value of Tests, Risk Factors, Retrospective Studie, Internal medicine, medicine, Humans, Risk stratification, Proportional Hazards Models, Retrospective Studies, Aged, Neoplasm Staging, business.industry, Risk Factor, Risk group, Prostatic Neoplasms, Middle Aged, Prostate-Specific Antigen, medicine.disease, Europe, Survival Rate, Area Under Curve, Prostatic Neoplasm, Proportional Hazards Model, Neoplasm Grading, business, Human
Abstract

Background High-risk prostate cancer (PCa) is an extremely heterogeneous disease. A clear definition of prognostic subgroups is mandatory. Objective To develop a pretreatment prognostic model for PCa-specific survival (PCSS) in high-risk PCa based on combinations of unfavorable risk factors. Design, setting, and participants We conducted a retrospective multicenter cohort study including 1360 consecutive patients with high-risk PCa treated at eight European high-volume centers. Intervention Retropubic radical prostatectomy with pelvic lymphadenectomy. Outcome measurements and statistical analysis Two Cox multivariable regression models were constructed to predict PCSS as a function of dichotomization of clinical stage ( 20 ng/ml). The first "extended" model includes all seven possible combinations; the second "simplified" model includes three subgroups: a good prognosis subgroup (one single high-risk factor); an intermediate prognosis subgroup (PSA > 20 ng/ml and stage cT3-4); and a poor prognosis subgroup (GS 8-10 in combination with at least one other high-risk factor). The predictive accuracy of the models was summarized and compared. Survival estimates and clinical and pathologic outcomes were compared between the three subgroups. Results and limitations The simplified model yielded an R of 33% with a 5-yr area under the curve (AUC) of 0.70 with no significant loss of predictive accuracy compared with the extended model (R: 34%; AUC: 0.71). The 5- and 10-yr PCSS rates were 98.7% and 95.4%, 96.5% and 88.3%, 88.8% and 79.7%, for the good, intermediate, and poor prognosis subgroups, respectively (p = 0.0003). Overall survival, clinical progression-free survival, and histopathologic outcomes significantly worsened in a stepwise fashion from the good to the poor prognosis subgroups. Limitations of the study are the retrospective design and the long study period. Conclusions This study presents an intuitive and easy-to-use stratification of high-risk PCa into three prognostic subgroups. The model is useful for counseling and decision making in the pretreatment setting.

Published
2015

35. Re: Stephen H. Culp, Paul F. Schellhammer, Michael B. Williams. Might men diagnosed with metastatic prostate cancer benefit from definitive treatment of the primary tumor? A SEER-based study. Eur Urol 2014;65:1058-66

Author

Piet Ost, Gianluca Giannarini, Alberto Briganti, Ost, Piet, Briganti, Alberto, and Giannarini, Gianluca

Subjects
Gynecology, Oncology, Male, medicine.medical_specialty, business.industry, Urology, Medicine (all), MEDLINE, Adenocarcinoma, medicine.disease, Primary tumor, Prostate cancer, Internal medicine, Prostatic Neoplasm, Medicine, business, Human
Published
2014

36. Prediction of outcome following early salvage radiotherapy among patients with biochemical recurrence after radical prostatectomy

Author

Pierre I. Karakiewicz, Shahrokh F. Shariat, Karin Haustermans, Francesco Montorsi, R. Jeffrey Karnes, Thomas Wiegel, Stephen A. Boorjian, Cesare Cozzarini, Wolfgang Hinkelbein, Bertrand Tombal, Steven Joniau, Maxine Sun, Hendrik Van Poppel, Alberto Briganti, Giorgio Gandaglia, Briganti, Alberto, Karnes, Rj, Joniau, S, Boorjian, Sa, Cozzarini, C, Gandaglia, G, Hinkelbein, W, Haustermans, K, Tombal, B, Shariat, S, Sun, M, Karakiewicz, Pi, Montorsi, Francesco, Van Poppel, H, and Wiegel, T.

Subjects
Oncology, Biochemical recurrence, Male, medicine.medical_specialty, Neoplasm, Residual, medicine.medical_treatment, Urology, Nomogram, Disease-Free Survival, Follow-Up Studie, Prostate cancer, Prostate, Retrospective Studie, Internal medicine, medicine, Humans, Survival rate, Retrospective Studies, Neoplasm Staging, Prostatectomy, Salvage Therapy, business.industry, Proportional hazards model, Medicine (all), Prostatic Neoplasms, Middle Aged, Prostate-Specific Antigen, medicine.disease, Radical prostatectomy, Surgery, Salvage radiotherapy, Survival Rate, Nomograms, medicine.anatomical_structure, Cohort, Prostatic Neoplasm, Neoplasm Grading, Neoplasm Recurrence, Local, business, Follow-Up Studies, Human
Abstract

Background Early salvage radiotherapy (eSRT) represents the only curative option for prostate cancer patients experiencing biochemical recurrence (BCR) for local recurrence after radical prostatectomy (RP). Objective To develop and internally validate a novel nomogram predicting BCR after eSRT in patients treated with RP. Design, setting, and participants Using a multi-institutional cohort, 472 node-negative patients who experienced BCR after RP were identified. All patients received eSRT, defined as local radiation to the prostate and seminal vesicle bed, delivered at prostate-specific antigen (PSA) ≤0.5 ng/ml. Outcome measurement and statistical analysis BCR after eSRT was defined as two consecutive PSA values ≥0.2 ng/ml. Uni- and multivariable Cox regression models predicting BCR after eSRT were fitted. Regression-based coefficients were used to develop a nomogram predicting the risk of 5-yr BCR after eSRT. The discrimination of the nomogram was quantified with the Harrell concordance index and the calibration plot method. Two hundred bootstrap resamples were used for internal validation. Results and limitations Mean follow-up was 58 mo (median: 48 mo). Overall, 5-yr BCR-free survival rate after eSRT was 73.4%. In univariable analyses, pathologic stage, Gleason score, and positive surgical margins were associated with the risk of BCR after eSRT (all p ≤ 0.04). These results were confirmed in multivariable analysis, where all the previously mentioned covariates as well as pre-RT PSA were significantly associated with BCR after eSRT (all p ≤ 0.04). A coefficient-based nomogram demonstrated a bootstrap-corrected discrimination of 0.74. Our study is limited by its retrospective nature and use of BCR as an end point. Conclusions eSRT leads to excellent cancer control in patients with BCR for presumed local failure after RP. We developed the first nomogram to predict outcome after eSRT. Our model facilitates risk stratification and patient counselling regarding the use of secondary therapy for individuals experiencing BCR after RP. Patient summary Salvage radiotherapy leads to optimal cancer control in patients who experience recurrence after radical prostatectomy. We developed a novel tool to identify the best candidates for salvage treatment and to allow selection of patients to be considered for additional forms of therapy. © 2013 European Association of Urology.

Published
2014

37. Reply to E. David Crawford and Bo-Eric Persson's letter to the editor re: Giorgio Gandaglia, Maxine Sun, Jim C. Hu, et al. gonadotropin-releasing hormone agonists and acute kidney injury in patients with prostate cancer. Eur Urol. in press. http://dx.doi.org/10.1016/j.eururo.2014.01.026

Author

Giorgio, Gandaglia, Maxine, Sun, Alberto, Briganti, Pierre I, Karakiewicz, Gandaglia, Giorgio, Sun, Maxine, Briganti, Alberto, and Karakiewicz, Pierre I.

Subjects
Male, Prostatectomy, Gonadotropin-Releasing Hormone, Medicine (all), Urology, Prostatic Neoplasm, Humans, Prostatic Neoplasms, Acute Kidney Injury, Human
Published
2014

38. Expression-profiling of apoptosis induced by ablation of the long ncRNA TRPM2-AS in prostate cancer cell

Author

Francesco Montorsi, Alberto Briganti, Giovanni Lavorgna, Andrea Salonia, Diego Pasini, Fulvio Chiacchiera, Lavorgna, Giovanni, Chiacchiera, Fulvio, Briganti, Alberto, Montorsi, Francesco, Pasini, Diego, and Salonia, Andrea

Subjects
NcRNA, Microarray, lcsh:QH426-470, Regulator, Apoptosis, Biology, Bioinformatics, Biochemistry, Prostate cancer, Data in Brief, medicine, Genetics, Prostate cancer, ncRNA, Apoptosis, Microarray, Ion channel, Microarray analysis techniques, RNA, Apoptosi, medicine.disease, Non-coding RNA, ncRNA, Gene expression profiling, lcsh:Genetics, Cancer research, Molecular Medicine, Ion channel, Biotechnology
Abstract

We recently identified the long non-coding RNA (ncRNA) TRPM2-AS as a key regulator of survival in prostate cancer [1]. This essential role, coupled to the TRPM2-AS low-expression levels in healthy tissues, makes this ncRNA a suitable therapeutic target for further clinical studies. To get insights into the survival mechanism controlled by this molecule, we ablated its expression in prostate cancer cells and performed a genome-wide analysis of the transcripts differentially regulated in dying cells. Here, we describe in detail the experimental system, methods and quality control for the generation of the microarray data associated with our recent publication [1]. The data are related to [1]. Data have been deposited to the Gene Expression Omnibus (GEO) database repository with the dataset identifier GSE40687.

Published
2015

39. Clinical factors predicting late severe urinary toxicity after postoperative radiotherapy for prostate carcinoma: a single-institute analysis of 742 patients

Author

Sara Broggi, Angelo Bolognesi, Marcella Pasetti, Lucia Perna, G. Salvadori, Luigi F. Da Pozzo, Cesare Cozzarini, Claudio Fiorino, Nadia Di Muzio, Francesco Montorsi, G. Berardi, Giorgio Guazzoni, Patrizio Rigatti, Filippo Alongi, Alberto Briganti, A.M. Deli, Cozzarini, C, Fiorino, C, DA POZZO, L, Alongi, F, Berardi, G, Bolognesi, A, Briganti, A, Broggi, S, Deli, A, Guazzoni, G, Perna, L, Pasetti, M, Salvadori, G, Di Muzio, N, Da Pozzo, Lf, Briganti, Alberto, Montorsi, Francesco, Rigatti, P, and Di Muzio, N.

Subjects
Male, Cancer Research, medicine.medical_treatment, Gastroenterology, Prostate cancer, Prostate, Intensity-Modulated, Adjuvant, Univariate analysis, Radiation, Radiotherapy Dosage, Middle Aged, medicine.anatomical_structure, Oncology, urinary toxicity, postoperative radiotherapy, prostate carcinoma, Cohort, Toxicity, Hypertension, Salvage, Risk, medicine.medical_specialty, Urinary system, Urinary Bladder, Hemorrhage, Sensitivity and Specificity, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Radiation Injuries, Aged, Prostatectomy, Salvage Therapy, Urethral Stricture, Analysis of Variance, Radiotherapy, business.industry, Prostatic Neoplasms, Urinary toxicity, Follow-Up Studies, ROC Curve, Radiotherapy, Adjuvant, Radiotherapy, Intensity-Modulated, Urinary Incontinence, medicine.disease, Acute toxicity, Surgery, Radiation therapy, business
Abstract

Purpose: To investigate the clinical factors independently predictive of long-term severe urinary sequelae after postprostatectomy radiotherapy. Patients and Methods: Between 1993 and 2005, 742 consecutive patients underwent postoperative radiotherapy with either adjuvant (n = 556; median radiation dose, 70.2 Gy) or salvage (n = 186; median radiation dose, 72 Gy) intent. Results: After a median follow-up of 99 months, the 8-year risk of Grade 2 or greater and Grade 3 late urinary toxicity was almost identical (23.9% vs. 23.7% and 12% vs. 10%) in the adjuvant and salvage cohorts, respectively. On univariate analysis, acute toxicity was significantly predictive of late Grade 2 or greater sequelae in both subgroups (p 72 Gy (8-year risk, 19% vs. 6%, p = .007) and age >71 years (8-year risk, 16% vs. 6%,p = .006) in the salvage subgroup. Multivariate analysis confirmed the independent predictive role of all the covariates indicated as statistically significant on univariate analysis. Conclusions: The risk of late Grade 2 or greater and Grade 3 urinary toxicity was almost identical, regardless of the RT intent. In the salvage cohort, older age and greater radiation doses resulted in a worse toxicity profile, and younger, hypertensive patients experienced a greater rate of severe late sequelae in the adjuvant setting. The causes of this latter correlation and apparently different etiopathogenesis of chronic damage in the two subgroups were unclear and deserve additional investigation. (C) 2012 Elsevier Inc.

Published
2012

40. The role of choline positron emission tomography/computed tomography in the management of patients with prostate-specific antigen progression after radical treatment of prostate cancer

Author

Alberto Briganti, George N. Thalmann, Stefano Fanti, Bernd J. Krause, Maria Picchio, Axel Heidenreich, Francesco Montorsi, Cristina Messa, Sven N. Reske, Picchio, M, Briganti, A, Fanti, S, Heidenreich, A, Krause, B, Messa, M, Montorsi, F, Reske, S, Thalmann, G, Briganti, Alberto, Krause, Bj, Messa, C, Montorsi, Francesco, Reske, Sn, Thalmann, Gn, Picchio M., Briganti A., Fanti S., Heidenreich A., Krause B.J., Messa C., Montorsi F., Reske S.N., and Thalmann G.N.

Subjects
Biochemical recurrence, Male, Time Factors, Time Factor, PET/CT, medicine.medical_treatment, Urology, Molecular imaging, Context (language use), Predictive Value of Test, Choline, Prostate cancer, Predictive Value of Tests, Recurrence, medicine, Humans, Carbon Radioisotopes, Neoplasm Staging, Prostatectomy, PET-CT, medicine.diagnostic_test, business.industry, Prostatic Neoplasms, Prostate-Specific Antigen, medicine.disease, Radiation therapy, Prostate-specific antigen, PET, Treatment Outcome, Positron emission tomography, Positron-Emission Tomography, Prostatic Neoplasm, Radiopharmaceutical, Radiopharmaceuticals, Neoplasm Recurrence, Local, Nuclear medicine, business, Tomography, X-Ray Computed, Emission computed tomography, Carbon Radioisotope, Human
Abstract

Context: Choline positron emission tomography (PET)/computed tomography (CT) is a currently used diagnostic tool in restaging prostate cancer (PCa) patients with increasing prostate-specific antigen (PSA) after either radical prostatectomy (RP) or external-beam radiation therapy (EBRT). However, no final recommendations have been made on the use of this modality for patient management. Objective: To critically analyse the current evidence for the use of choline PET/CT scanning in the management of patients with a progressive increase in PSA after radical treatment for PCa, evaluating its diagnostic accuracy in the detection of recurrences, the clinical predictors of positive PET/CT examinations, and the modalities' role as a guide for tailored therapeutic strategies. Evidence acquisition: Data on recently published (2003-2010) original articles, review articles, and editorials concerning the role of choline PET/CT in this scenario were analysed. Evidence synthesis: The diagnostic accuracy of choline PET in detecting sites of PCa relapse has been investigated by several authors, and the overall reported sensitivity ranges between 38% and 98%. It has been demonstrated that choline PET technology's positive detection rate improves with increasing PSA values. The routine use of choline PET/CT cannot be recommended for PSA values

Published
2011
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41. Risk of Metachronous Upper Tract Urothelial Carcinoma After Ureteral Stenting in Patients With Bladder Cancer.

Author

Scilipoti P, Moschini M, de Angelis M, Longoni M, Afferi L, Lonati C, Zaurito P, Pichler R, Necchi A, Montorsi F, Briganti A, Mari A, Krajewski W, Laukthina E, Pradere B, Giudice FD, Mertens L, Gallioli A, Soria F, Gontero P, Albisinni S, Shariat SF, and Carando R

Subjects
Humans, Male, Female, Aged, Retrospective Studies, Middle Aged, Neoplasms, Second Primary surgery, Neoplasms, Second Primary pathology, Cystectomy, Hydronephrosis etiology, Carcinoma, Transitional Cell surgery, Carcinoma, Transitional Cell pathology, Nephrostomy, Percutaneous, Ureteral Neoplasms surgery, Ureteral Neoplasms pathology, Follow-Up Studies, Stents, Urinary Bladder Neoplasms surgery, Urinary Bladder Neoplasms pathology
Abstract

Objective: Sparse data exist on the impact of upper urinary tract (UUT) decompression on the risk of UUT recurrence in patients with bladder cancer (BCa). This study aims to evaluate whether Double J stenting (DJS) can increase the risk of UUT recurrence compared to percutaneous nephrostomy (PCN) placement., Materials and Methods: We retrospectively analyzed data from 1550 patients with cTa-T3NanyM0 BCa who underwent radical cystectomy (RC) between at 12 tertiary care centers (1990-2020). Patients with complete follow-up, no prior history of UUT cancer, and who required UUT decompression for preoperative hydronephrosis were selected. Hydronephrosis grade was defined according to established scoring systems. UUT recurrence was diagnosed through imaging, urinary cytology, and confirmed by selective cytology and ureteroscopy when possible. Propensity scores were computed to determine overlap weights and balance groups. Kaplan-Meier analyses estimated UUT recurrence-free survival (RFS), cancer-specific (CSS), and overall survival (OS) before and after weighting. Cox regression analyses before and after weighting were fitted to predict UUT recurrence., Results: Of 524 included patients, 132 (25%) and 392 (75%) patients were managed with DJS and PCN placement, respectively. Patients who received PCN had higher grade (≥ 3) of obstruction (34% vs. 14%) and pT3-4 tumors (70% vs. 36%) than patients with DJS. During a median follow-up of 19 months, 2-years UUT-RFS did not differ between groups (95% for PCN vs 92% for DJS, weighted HR 1.41, 95% CI, 0.55-3.59). There was no difference in 2-years weighted CSS (74% vs. 74%) and OS (67% vs 69%). Main limitations were the short follow-up and inclusion of patients uniquely undergoing RC., Conclusions: These results suggest that ureteral DJS does not increase the risk of developing UUT recurrence in BCa patients with hydronephrosis requiring UUT decompression. However, UUT recurrence was rare, and associations were weak, with findings susceptible to bias. Randomized trials are needed to validate these results., Competing Interests: Disclosure All authors declare no conflict of interest relative to the content of the paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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42. The Impact of Radical Prostatectomy Versus Radiation Therapy on Cancer-Specific Mortality for Nonmetastatic Prostate Cancer: Analysis of an Other-Cause Mortality Matched Cohort.

Author

Finati M, Corsi NJ, Stephens A, Chiarelli G, Cirulli GO, Davis M, Tinsley S, Sood A, Buffi N, Lughezzani G, Salonia A, Briganti A, Montorsi F, Bettocchi C, Carrieri G, Rogers C, and Abdollah F

Subjects
Humans, Male, Aged, Middle Aged, Neoplasm Grading, Propensity Score, Treatment Outcome, Cohort Studies, Prostatic Neoplasms radiotherapy, Prostatic Neoplasms mortality, Prostatic Neoplasms surgery, Prostatic Neoplasms pathology, Prostatectomy, SEER Program
Abstract

Introduction: Studies comparing radical prostatectomy (RP) to radiation therapy (RT) have consistently shown that patients undergoing RT have a higher risk of other-cause mortality (OCM) compared to RP, signifying poor health status of the former patients. We aimed to evaluate the impact of RP versus RT on cancer-specific mortality (CSM) over a cohort with equivalent OCM risk., Patients and Methods: The SEER database was queried to identify patients with nonmetastatic PCa between 2004 and 2009. Patients were matched based on their calculated 10-year OCM risk and further stratified for D'Amico Risk Score and Gleason Grade. A Cox-regression model was used to calculate the 10-year OCM risk. Propensity-score based on the calculated OCM risk were used to match RP and RT patients. Cumulative incidence curves and Competing-risk regression analyses were used to examine the impact of treatment on CSM in the matched cohort., Results: We identified 55,106 PCa patients treated with RP and 36,674 treated with RT. After match, 6,506 patients were equally distributed for RT versus RP, with no difference in OCM rates (P = .2). The 10-year CSM rates were 8.8% versus 0.6% (P = .01) for RT versus RP in patients with unfavorable-intermediate-risk (Gleason Score 4 + 3) and 7.9% versus 3.9% (P = .003) for high-risk disease. There was no difference in CSM among RT and RP patients for favorable-intermediate-risk (Gleason Score 3 + 4) and low-risk disease., Conclusions: In a matched cohort of PCa patients with comparable OCM between the 2 arms, RP yielded a more favorable CSM rate compared to RT only for unfavorable-intermediate- and high-risk groups., Competing Interests: Disclosure None of the authors have any relevant disclosures, and none of the authors have any financial or nonfinancial interests that may be relevant to the submitted work., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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43. Mitomycin C vs. Bacillus Calmette-Guerin for treatment of intermediate-risk nonmuscle invasive bladder cancer patients-A comparative analysis from a single center.

Author

Scilipoti P, Longoni M, de Angelis M, Re C, Bertini A, Cannoletta D, Burgio G, Lucianò R, Rosiello G, Colombo R, Gandaglia G, Salonia A, Montorsi F, Briganti A, and Moschini M

Subjects
Humans, Female, Male, Retrospective Studies, Aged, Middle Aged, Administration, Intravesical, Antibiotics, Antineoplastic therapeutic use, Antibiotics, Antineoplastic administration & dosage, Adjuvants, Immunologic therapeutic use, Adjuvants, Immunologic administration & dosage, Treatment Outcome, Urinary Bladder Neoplasms drug therapy, Urinary Bladder Neoplasms pathology, Mitomycin therapeutic use, Mitomycin administration & dosage, BCG Vaccine therapeutic use, BCG Vaccine administration & dosage, Neoplasm Invasiveness
Abstract

Background: Induction followed by 1 year maintenance instillation of intravesical Bacillus Calmette-Guerin (BCG) is the standard treatment for intermediate-risk (IR) nonmuscle invasive bladder cancer (NMIBC) patients. Few data exist on the efficacy of Mitomycin C (MMC) instillation in this setting., Methods: We retrospectively analyzed 226 IR-NMIBC patients classified by the International Bladder Cancer Group (IBCG) and 250 IR-NMIBC intravescical treatment-naïve patients classified by the European Association of Urology (EAU). All patients received either a full induction course of BCG or 40 mg/40 ml MMC from 2012 to 2022. Optimal treatment was defined as 1-year maintenance for BCG and 11 monthly maintenance instillations for MMC. Kaplan-Meier analysis estimated recurrence-free survival (RFS) before and after inverse probability of treatment-weighting (IPTW) and progression-free survival (PFS). Multivariable Cox regression was used to evaluate difference in recurrence after adjustment for clinically relevant variables before and after IPTW., Results: Optimal BCG and MMC courses were administered to 21% of IR-IBCG and 23% of IR-EAU patients. At 4-years, patients treated with optimal MMC and BCG treatment had similar RFS and PFS in both EAU and IBCG groups. Patients receiving nonoptimal BCG compared to optimal MMC exhibited lower 4-year RFS after IPTW (82% vs. 68% in EAU and 82% vs. 65% in IBCG). At 4-year optimal MMC had greater PFS non optimal BCG. Optimal MMC treatment predicted recurrence in EAU (adjusted and weighted HR 0.33, 95% CI, 0.11-0.98) and IBCG (adjusted and weighted HR 0.29, 95% CI, 0.08-0.97) groups compared to nonoptimal BCG., Conclusions: Optimal 40 mg/40 ml MMC treatment was as effective as optimal BCG in IR-IBCG and IR-EAU NMIBC patients, reducing both recurrence and progression compared to nonoptimal BCG. MMC could be a valid first line alternative to BCG for both IR-EAU and IR-IBCG intravescical treatment-naïve patients, during BCG shortages., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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44. Exploring the effect of patient characteristics on the association between warm ischemia time and the risk of postoperative acute kidney injury after partial nephrectomy.

Author

Scilipoti P, Rosiello G, Belladelli F, Pellegrino F, Trevisani F, Bettiga A, Re C, Musso G, Cei F, Salerno L, Tian Z, Karakiewicz PI, Mottrie A, Rowe I, Matloob R, Briganti A, Bertini R, Salonia A, Montorsi F, Larcher A, and Capitanio U

Abstract

Background: The impact of warm ischemia time (WIT) on renal function after partial nephrectomy (PN) remains debated. This study investigates the effect of WIT on the relationship between preoperative comorbidities and postoperative renal function impairment in renal cell carcinoma (RCC) patients., Methods: Patients undergoing PN for T1 RCC at a European high-volume center (2000-2023) were analyzed. Logistic regressions assessed the association between patient comorbidities and acute kidney injury (AKI). Patients were stratified into low (LR), intermediate (IR), and high-risk (HR) groups based on a weighted comorbidity score derived from odds-ratio obtained from the logistic regression analysis. Interaction terms and a weighted local polynomial smoother function assessed the impact of WIT on AKI. Cox regressions and cumulative incidence were used to assess the chronic kidney disease (CKD) upstage ≥IIIB risk according to AKI and risk groups., Results: Of 1,048 patients, 802 underwent PN with warm ischemia. Among these, 339(42%), 208(26%), 255(32%) were classified as LR, IR and HR. IR (OR:1.82, P = 0.018) and HR (OR:3.01, P < 0.001) patients had a higher AKI risk compared to LR. The increase in WIT had little impact on the LR AKI probability compared to IR (OR:1.06, P = 0.001) and HR (OR:1.08, P < 0.001). The 10-year risk of CKD-upstage ≥IIIB was higher (36% vs. 12%, HR:2.40, P = 0.004) after AKI, and in the HR group (HR:2.42, P = 0.008) CONCLUSIONS: WIT predominantly affected the risk of AKI in HR patients for renal function impairment after surgery. Preoperative counseling is essential for comorbid patients, especially when planning complex surgeries with prolonged ischemia, to mitigate AKI and long-term renal impairment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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45. Primary tumor ablation in metastatic renal cell carcinoma.

Author

Scheipner L, Incesu RB, Morra S, Baudo A, Jannello LMI, Siech C, de Angelis M, Assad A, Tian Z, Saad F, Shariat SF, Briganti A, Chun FKH, Tilki D, Longo N, Carmignani L, De Cobelli O, Pichler M, Ahyai S, and Karakiewicz PI

Abstract

Background: The role of primary tumor ablation (pTA) in metastatic renal cell carcinoma (mRCC) is unknown. We compared pTA-treated mRCC patients to patients who underwent no local treatment (NLT), as well as patients who underwent cytoreductive nephrectomy (CN)., Methods: Within the Surveillance, Epidemiology, and End Results database (SEER, 2004-2020), we identified mRCC patients who underwent either pTA, NLT or CN. Endpoints consisted of overall survival (OM) and other-cause mortality (OCM). Propensity score 1:1 matching (PSM), multivariable cox regression models (OM), as well as, multivariable competing risk regressions (CRR) models (OCM) were used., Results: We identified 27,087 mRCC patients, of whom 82 (0.3%) underwent pTA, 17,266 (64%) NLT and 9,739 (36%) CN. In comparisons of pTA vs. NLT mRCC patients addressing OM, after 1:1 PSM, median survival was 19 months for pTA vs. 4 months for NLT patients (multivariable HR 0.3, 95% CI 0.22-0.47, P < 0.001). No statistically significant OCM differences were recorded in multivariable CRR (HR 1.13 95%, CI 0.52-2.44, P = 0.8). In comparisons of pTA vs. CN, after 1:1 PSM, no statistically significant differences in OM (HR 1.22, 95% CI 0.81-1.83, P = 0.32), as well as OCM (HR 1.4, 95% CI 0.56-3.48, P = 0.5) were recorded., Conclusion: In mRCC patients, pTA is associated with significantly lower mortality compared to NLT. Interestingly, OM rates between pTA and CN mRCC patients do not exhibit statistically significant differences. This preliminary report may suggest that pTA may provide a comparable survival benefit to CN in highly selected mRCC patients., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2024
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46. Critical care therapy and in-hospital mortality after radical nephroureterectomy for nonmetastatic upper urinary tract carcinoma.

Author

Di Bello F, Siech C, de Angelis M, Rodriguez Peñaranda N, Tian Z, Goyal JA, Collà Ruvolo C, Califano G, Creta M, Saad F, Shariat SF, Briganti A, Chun FKH, Puliatti S, Longo N, and Karakiewicz PI

Abstract

Background: Use of critical care therapies (CCT), that include invasive mechanical ventilation (IMV), total parenteral nutrition (TPN) and other modalities are unknown after radical nephroureterectomy (RNU) for upper urinary tract carcinoma (UUTC). Their relationship with in-hospital mortality is also unknown., Methods: Within the National Inpatient Sample (2008-2019), we identified non-metastatic UUTC patients treated with RNU. Multivariable logistic regression models were used., Results: Of 8,995 patients, 375 (4.2%) received CCT and 82 (0.9%) experienced in-hospital mortality. Of CCT modalities, 215 (2.4%) received IMV and 139 (1.5%) TPN. Temporal CCT, IMV, and TPN trends very closely followed in-hospital mortality trends. Relative to historical UUTC patients (2008-2013), contemporary (2014-2019) patients exhibited lower CCT (Δ = 2.2%, P value < 0.0001), lower IMV (Δ = 1.4%, P < 0.0001), lower TPN (Δ = 2.2%, P < 0.0001), and lower in-hospital mortality (Δ = 0.4%, P = 0.03) rates. Of in-hospital mortalities, 52 out of 82 received CCT but 30 of 82 did not. Median age (> 72 years; odds ratio [OR] 1.4; P = 0.002) and Charlson comorbidity index ≥ 3 (OR 4.1; P < 0.001) and ≥ 1-2 (OR 1.7; P = 0.001) independently predicted overall higher CCT, IMV, TPN, and in-hospital mortality., Conclusion: After RNU, CCT rates parallels in-hospital mortality rates. CCT represents a 5 to 6-fold multiple of in-hospital mortality rate. In RNU patients, CCT rates are higher in older and sicker individuals. Lower CCT rates that are paralleled by lower in-hospital mortality may be interpreted as an indicator of improved quality of care. Ideally all in-hospital mortalities should be predated by CCT exposure., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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47. Survival of Metastatic Urothelial Carcinoma of Urinary Bladder According to Number and Location of Visceral Metastases.

Author

Di Bello F, de Angelis M, Siech C, Jannello LMI, Peñaranda NR, Tian Z, Goyal JA, Ruvolo C, Califano G, La Rocca R, Saad F, Shariat SF, de Cobelli O, Briganti A, Chun FKH, Puliatti S, Longo N, and Karakiewicz PI

Subjects
Humans, Male, Female, Aged, Middle Aged, Prognosis, Survival Rate, Retrospective Studies, Aged, 80 and over, Urinary Bladder Neoplasms pathology, Urinary Bladder Neoplasms mortality, SEER Program, Carcinoma, Transitional Cell mortality, Carcinoma, Transitional Cell secondary
Abstract

Objective: To test the association between number as well as locations of organ-specific metastatic sites and overall survival (OS) in systhemic-therapy exposed metastatic urothelial carcinoma of urinary bladder (mUCUB) patients., Methods: Within Surveillance, Epidemiology and End Results database (2010-2020), all systhemic therapy-exposed mUCUB patients were identified. Kaplan-Meier and multivariable Cox regression (CRM) models first addressed OS in patients according to number of metastatic organ-locations: solitary versus 2 versus 3 or more. Subsequently, separate analyses stratified according to location type were completed in patients with solitary metastatic organ-location as well as in patients with 2 metastatic organ-locations., Results: Of 1,310 mUCUB, 1,069 (82%) harbored solitary metastatic organ-location versus 193 (15%) harbored 2 separate metastatic organ-locations versus 48 (3%) harbored 3 or more metastatic organ-locations. Median OS decreased with increasing number of metastatic organ-locations (solitary vs. 2 vs. 3 or more, P < .0001). In multivariable CRM, relative to solitary metastatic organ-location, 2 (HR: 1.57, 95 Confidence interval [CI], 1.33-1.85) as well as 3 or more (HR: 1.69, 95% CI, 1.23-2.31) metastatic organ-locations independently predicted higher overall mortality (OM) (P = .001). In patients with solitary metastatic organ-location, brain metastases independently predicted higher OM (HR 1.67; 95% CI, 1.05-2.67; P = .03) than other locations. In patients with 2 metastatic organ-locations, no differences in OM were recorded according to organ type location., Conclusion: In systemic therapy exposed mUCUB, number of metastatic organ-locations (solitary vs. 2 vs. 3 or more), independently predicted increasingly worse prognosis. In patients with solitary metastatic organ-location, brain purported worse prognosis than others., Competing Interests: Disclosure The authors declare no conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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48. Neoadjuvant Versus Adjuvant Chemotherapy in Non-Metastatic Locally-Advanced Stage Radical Cystectomy Candidates.

Author

de Angelis M, Siech C, Jannello LMI, Bello FD, Peñaranda NR, Goyal JA, Touma N, Tian Z, Longo N, de Cobelli O, Chun FKH, Micali S, Saad F, Shariat SF, Gandaglia G, Moschini M, Montorsi F, Briganti A, and Karakiewicz PI

Subjects
Humans, Male, Female, Chemotherapy, Adjuvant methods, Aged, Middle Aged, SEER Program, Retrospective Studies, Treatment Outcome, Cystectomy, Neoadjuvant Therapy methods, Urinary Bladder Neoplasms drug therapy, Urinary Bladder Neoplasms surgery, Urinary Bladder Neoplasms pathology, Neoplasm Staging
Abstract

Introduction: Administration of chemotherapy before radical cystectomy (RC) in neoadjuvant setting (NAC) or after RC in adjuvant setting (ADJ) are both associated with a survival benefit relative to RC alone. However, no study directly compared the magnitude of such benefit associated with NAC versus ADJ in locally-advanced UCUB patients (T3-T4N0M0). We addressed this knowledge gap., Methods: Within the Surveillance, Epidemiology, and End Results database (2007-2020), we identified T3-T4N0M0 UCUB patients who underwent NAC+RC or RC+ADJ. Cumulative incidence plots and multivariable competing risks regression (CRR) models were fitted. The same methodology was then re-applied in T3 and then T4 patient subgroups., Results: Of 875 assessable patients, 603 harbored T3 stage (69.0%) and 272 harbored T4 stage (31.0%). Of all 875, 563 (64.0%) underwent RC+ADJ versus 312 (36.0%) NAC+RC. NAC+RC rates increased over time (EAPC=+6.1%, P = .001). Cumulative incidence plots derived five-year CSM rates were 40.3% in NAC+RC versus 36.1% in RC+ADJ patients (P = .2). In multivariable CRR models that also adjusted for OCM, no statistically significant difference in CSM was recorded when NAC+RC was compared to RC+ADJ (HR:0.85, P = .1). Virtually the same observations were made in subgroup analyses where CSM associated with NAC+RC was not different from that recorded in RC+ADJ (HR: 0.89 and P = .4 in T3 stage and HR:0.8 and P = .2 in T4 stage)., Conclusion: In locally-advanced UCUB, NAC rates have sharply increased over time. However, the approach based on neoadjuvant chemotherapy prior to RC have not resulted in a statistically significant CSM benefit relative to RC+ADJ., Competing Interests: Disclosure None., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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49. Regional Differences in Stage III Nonseminoma Germ Cell Tumor Patients Across SEER Registries.

Author

Cano Garcia C, Barletta F, Tappero S, Piccinelli ML, Incesu RB, Morra S, Scheipner L, Tian Z, Saad F, Shariat SF, Ahyai S, Longo N, Tilki D, De Cobelli O, Terrone C, Briganti A, Banek S, Kluth LA, Chun FKH, and Karakiewicz PI

Subjects
Humans, Male, United States epidemiology, Adult, Young Adult, Registries statistics & numerical data, Prognosis, Middle Aged, Lymph Node Excision statistics & numerical data, Adolescent, Survival Rate, SEER Program, Neoplasms, Germ Cell and Embryonal therapy, Neoplasms, Germ Cell and Embryonal pathology, Neoplasms, Germ Cell and Embryonal mortality, Neoplasms, Germ Cell and Embryonal epidemiology, Testicular Neoplasms pathology, Testicular Neoplasms therapy, Testicular Neoplasms mortality, Neoplasm Staging
Abstract

Purpose: We investigated regional differences in patients with stage III nonseminoma germ cell tumor (NSGCT). Specifically, we investigated differences in baseline patient, tumor characteristics and treatment characteristics, as well as cancer-specific mortality (CSM) across different regions of the United States., Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database (2004-2018), patient (age, race/ethnicity), tumor (International Germ Cell Cancer Collaborative Group [IGCCCG] prognostic groups) and treatment (systemic therapy and retroperitoneal lymph dissection [RPLND] status) characteristics were tabulated for stage III NSGCT patients, according to 12 SEER registries representing different geographic regions. Multinomial regression models and multivariable Cox regression models testing for cancer-specific mortality (CSM) were used., Results: In 3,174 stage III NSGCT patients, registry-specific patient counts ranged from 51 (1.5%) to 1630 (51.3%). Differences across registries existed for age (12%-31% for age 40+), race/ethnicity (5%-73% for others than non-Hispanic whites), IGCCCG prognostic groups (24%-43% vs. 14-24% vs. 3%-20%, in respectively poor vs. intermediate vs. good prognosis), systemic therapy (87%-96%) and RPLND status (12%-35%). After adjustment, clinically meaningful inter-registry differences remained for systemic therapy (84%-97%) and RPLND (11%-32%). Unadjusted 5-year CSM rates ranged from 7.1% to 23.3%. Finally in multivariable analyses addressing CSM, 2 registries exhibited more favorable outcomes than SEER registry of reference (SEER Registry 12): SEER Registry 4 (Hazard Ratio (HR): 0.36) and SEER Registry 9 (HR: 0.64; both P = .004)., Conclusion: We identified important regional differences in patient, tumor and treatment characteristics, as well as CSM which may be indicative of regional differences in quality of care or expertise in stage III NGSCT management., Competing Interests: Disclosures The authors declare that they have no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Published
2024
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50. Rates of Systemic Therapy for Metastatic Bladder Cancer Are Lower in Unmarried Males and Females.

Author

Vitucci K, Siech C, Baudo A, Jannello LMI, de Angelis M, Bello FD, Goyal JA, Tian Z, Saad F, Shariat SF, Longo N, Carmignani L, de Cobelli O, Briganti A, Kluth LA, Chun FKH, and Karakiewicz PI

Subjects
Humans, Female, Male, Aged, Middle Aged, Carcinoma, Transitional Cell drug therapy, Carcinoma, Transitional Cell epidemiology, Carcinoma, Transitional Cell pathology, Aged, 80 and over, United States epidemiology, Single Person statistics & numerical data, Sex Factors, Retrospective Studies, Neoplasm Metastasis, Urinary Bladder Neoplasms pathology, Marital Status, SEER Program
Abstract

Objective: Systemic therapy is guideline-recommended for metastatic urothelial carcinoma of the urinary bladder (UCUB). Unmarried status represents an important barrier to treatment access in many primaries. The importance of married status is unknown in the context of systemic therapy in metastatic UCUB and was addressed in the current study., Methods: We relied on the Surveillance, Epidemiology, and End Results database (2004-2020) to identify patients with metastatic UCUB. Univariable and multivariable logistic regression models were fitted to address systemic therapy rates. Additionally, temporal trends were plotted., Results: Overall, 6873 patients with stage IV UCUB were identified. Of those, 4853 (71%) were male. Of males, 2993 (62%) were married vs. 797 (39%) of females. The rates of systemic therapy were 55% in both married males and married females. Married males and females differed from their unmarried counterparts regarding age and race/ethnicity. In males, prior to any adjustment, married status was associated with an odds ratio of 1.46 (P < .001). After adjustment for age and race/ethnicity, the odds ratio increased to 1.73 (P < .001). In females, prior to any adjustment, married status was associated with an odds ratio of 1.94 (P < .001). After adjustment for age and race/ethnicity, the odds ratio decreased to 1.57 (P < .001)., Conclusion: Unmarried males and unmarried females are significantly exposed to lower access to systemic therapy compared to their married counterparts. In consequence, both unmarried men and unmarried women should be given very careful consideration when use of systemic therapy in metastatic UCUB is contemplated., Competing Interests: Disclosure The authors have stated that they have no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Published
2024
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