Minerva Urologica E Nefrologica最新文献

{"title":"Real-life data on long-term follow-up of patients successfully treated with percutaneous tibial nerve stimulation (PTNS).","authors":"D. Bianchi, V. Iacovelli, I. Parisi, F. Petta, G. Gaziev, L. Topazio, P. Bove, G. Vespasiani, Enrico Finazzi Agrò","doi":"10.23736/S0393-2249.19.03492-1","DOIUrl":"https://doi.org/10.23736/S0393-2249.19.03492-1","url":null,"abstract":"BACKGROUND\u0000The aim of this cross-sectional study is to evaluate the \"real life\" data of patients following successful treatment with PTNS for overactive bladder syndrome (OAB) or non-obstructive voiding dysfunction (NOVD) at a 7-year follow- up after the procedure.\u0000\u0000\u0000METHODS\u0000Patients who were successfully treated with PTNS for OAB or NOVD between February 2008 and January 2009 were contacted for a telephonic interview seven years after the end of their PTNS stimulation protocol. Patients who agreed to the interview were asked to complete a global response assessment (GRA). Patients in the OAB category completed the OAB short-form questionnaire Symptom Bother Scale (OAB-q SF) and the OAB Health-Related Quality of Life Scale (OAB HRQL), and NOVD patients were evaluated using the International Prostate Symptom Score - voiding questions (v-IPSS). Results of both questionnaires were compared with those obtained seven years previously, at the time of the initial PTNS treatment.\u0000\u0000\u0000RESULTS\u0000Seventeen patients were identified in our database. Sixteen agreed to the interview, but the remaining patient was unreachable and was therefore considered as lost at follow-up. Eight patients were classified into the OAB group, and eight were classified into the NOVD group. No patient reported a worsening condition after PTNS. Six of the eight patients (75%) in the OAB group gave positive responses in the GRA. All patients in the NOVD group gave positive responses in the GRA.\u0000\u0000\u0000CONCLUSIONS\u0000Despite some limitations, this study shows that the majority of patients who responded to PTNS considered themselves still improved at a seven- year follow-up. Larger studies are needed to confirm our results, but our study has the novel advantage of showing data derived from \"real life\" over the longest follow- up yet considered in the literature.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79229835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying tumor-related risk factors for simultaneous adrenalectomy in patients with cT1 - cT2 kidney cancer during robotic assisted laparoscopic radical nephrectomy.","authors":"J. Daza, A. Beksac, M. Kannappan, Julio T Chong, R. Abaza, A. Hemal, J. Sfakianos, K. Badani","doi":"10.23736/S0393-2249.19.03440-4","DOIUrl":"https://doi.org/10.23736/S0393-2249.19.03440-4","url":null,"abstract":"BACKGROUND\u0000In some cases, preservation of adrenal gland could be at risk in patients with cT1 and cT2 RCC. The aim of this study is to evaluate tumor-related factors that can potentially increase the risk of simultaneous adrenalectomy during robotic-assisted laparoscopic radical nephrectomy (RALRN) in patients with cT1 - cT2 disease and the impact of performing such procedure on recurrence-free survival (RFS) and complication rates.\u0000\u0000\u0000METHODS\u0000We used a multi-institutional kidney cancer database where we identified patients who underwent RALRN with or without adrenalectomy. We evaluated the tumor-related characteristics that could potentially increase the risk of adrenal gland resection of these patients. We also reported RFS at 12 - 24 months of follow-up, which was compared with an inverse probability of treatment weighted (IPTW) multivariable cox proportional hazards regression model and post-operative complications, which was compared with an IPTW multivariable logistic regression model.\u0000\u0000\u0000RESULTS\u0000Tumor size, cT stage, pT stage, histologic subtype, sarcomatoid differentiation, BMI, lymph node involvement, metastatic disease, Fuhrman grade do not increase the risk of simultaneous adrenalectomy during RALRN. Moreover, RALRN with adrenalectomy had no significant benefit in RFS. No differences in post-operative complications were noted.\u0000\u0000\u0000CONCLUSIONS\u0000Our evaluated tumor-related characteristics did not show to impact the incidence of simultaneous adrenalectomy. Adrenal gland resection T does not provide significant benefit in recurrence-free survival. We consider that RALRN with adrenalectomy should be reserved only for patients with adrenal compromise as stated previously regardless that it has shown to be a safe procedure.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82691810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of nerve-sparing surgery for high-risk prostate cancer.","authors":"A. Morozov, E. Barret, D. Veneziano, V. Grigoryan, G. Salomon, I. Fokin, M. Taratkin, E. Poddubskaya, J. Gómez Rivas, S. Puliatti, Z. Okhunov, G. Cacciamani, E. Checcucci, José L. Marenco Jiménez, D. Enikeev","doi":"10.23736/S0393-2249.20.04178-8","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04178-8","url":null,"abstract":"BACKGROUND\u0000We provide a systematic analysis of NSS to assess and summarize the risks and benefits of NSS in high-risk PCa.\u0000\u0000\u0000METHODS\u0000We have undertaken a systematic search of original articles at 3 databases (Medline (PubMed), Scopus, and Web of Science). Original articles in English containing outcomes of nerve-sparing RP for high-risk PCa were included. The primary outcomes were oncological results: the rate of positive surgical margins and biochemical relapse. The secondary outcomes were functional results: EF and urinary continence.\u0000\u0000\u0000RESULTS\u0000The rate of positive surgical margins differed considerably, from zero to 47%. The majority of authors found no correlation between NSS and a positive surgical margin rate. The rate of biochemical relapse ranged from 9.3% to 61%. Most of the articles lacked data on OR for positive margin and biochemical relapse. The presented results showed no effect of NS on positive margin (OR=0.81, 0.6-1.09) or biochemical relapse (HR=0.93, 0.52 1.64). A strong association between NSS and potency rate was observed. Without NSS, between 0% and 42% of patients were potent, with unilateral 79-80%, with bilateral - up to 90-100%. Urinary continence was not strongly associated with NSS and was relatively good in both patients with or without NSS.\u0000\u0000\u0000CONCLUSIONS\u0000NSS may provide benefits for patients with urinary continence and significantly improves EF in high-risk patients. Moreover, it is not associated with an increased risk of relapse in short- and middle-term follow-up. However, the advantages of using such a surgical technique are unclear.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84741015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Totally intracorporeal robotic ileal ureter replacement: focus on surgical technique and outcomes.","authors":"A. Grosso, F. di Maida, A. Mari, R. Campi, A. Crisci, G. Vignolini, L. Masieri, M. Carini, A. Minervini","doi":"10.23736/S0393-2249.20.04191-0","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04191-0","url":null,"abstract":"BACKGROUND\u0000Aim of the study was to describe our totally intracorporeal robotic ileal ureter replacement technique, reporting perioperative and mid-term results and compare it with previous similar experiences, specifically focusing on technical considerations.\u0000\u0000\u0000METHODS\u0000Three patients were submitted to robotic ileal ureter substitution for long ureteral defects in our institution during 2019. The procedures were carried out fully intracorporeally. Two patients received a complete replacement of the urinary tract using an ileal segment, while in one patient the lower ureteral stump was maintained, and an ileal-ureter anastomosis was performed distally. Patients' baseline characteristics, as well as, perioperative and mid-term results were collected. A detailed description of the technique is reported and compared with prior similar experiences.\u0000\u0000\u0000RESULTS\u0000Median operative time was 270 (range 240-300) min. No Clavien-Dindo complications >2 were collected. All patients experienced a fast return to oral intake and canalization. Antegrade pyelography, performed a 1-month follow-up, revealed full passage of the medium contrast in those patients submitted to complete ileal ureter replacement while, in the third one, stenosis at the level of ileal-ureter anastomoses was found.\u0000\u0000\u0000CONCLUSIONS\u0000Robotic ileal ureter replacement can be performed completely intracorporeal with optimal results and limited complication rate, in selected cases. According to our considerations, specific surgical steps are needed to reduce the risks related to this procedure, including avoiding partial ileal substitution.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89194114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of outcomes between laparoscopic and robot-assisted partial nephrectomy for complex renal tumors (RENAL score ≥ 7 or maximum tumor size > 4cm): a systematic review and meta-analysis.","authors":"Pengxiu Lin, Minhong Wu, Hong-li Gu, L. Tu, Shilan Liu, Zhiling Yu, Qingsheng Chen, Cailing Liu","doi":"10.23736/S0393-2249.20.04135-1","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04135-1","url":null,"abstract":"INTRODUCTION\u0000We reviewed current studies and performed a meta-analysis to compare outcomes between laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN) treating complex renal tumors (RENAL score ≥ 7 or maximum clinical tumor size > 4cm).\u0000\u0000\u0000EVIDENCE ACQUISITION\u0000Using the databases of PubMed, Embase, and the Cochrane Library, a comprehensive literature search was performed in April, 2020. Pooled odds ratios (ORs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated using fixed-effect or random-effect model. Publication bias was evaluated by funnel plots.\u0000\u0000\u0000EVIDENCE SYNTHESIS\u0000Ten observational studies including 5193 patients (LPN: 1574; RAPN: 3619) were included. There was no significant difference between the two groups regarding conversion to open (P = 0.07) surgery, all complications (P = 0.12), grade 1-2 complications (P = 0.10), grade 3-5 complications (P = 0.93), operative time (P = 0.94), estimated blood loss (P = 0.17). Patients undergoing LPN had a significant higher rate of conversion to radical (OR: 4.33; 95% CI: 2.01-9.33; p < 0.001), a longer ischemia time (IT, P < 0.001; WMD: 3.02 min; 95% CI, 1.67 to 4.36), a longer length of stay (LOS, P < 0.001; WMD: 0.67 days; 95% CI, 0.35 to 0.99), a lower rate of positive surgical margin (P = 0.03; OR: 0.71; 95% CI, 0.53 to 0.96), a greater eGFR decline (P < 0.001; WMD: 2.41 ml/min/1.73 m2; 95% CI, 1.22 to 3.60), a higher rate of CKD upstaging (P < 0.001; OR:2.44; 95% CI, 1.54 to 3.87). No obvious publication bias was observed.\u0000\u0000\u0000CONCLUSIONS\u0000For complex renal tumors, RAPN is more favorable than LPN in terms of lower rate of conversion to radical surgery, shorter IT, shorter LOS, less eGFR decline, and lower rate of CKD upstaging. Methodological limitations of observational studies should be taken into account in interpreting these results.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88376771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of perioperative outcomes of laparoscopic versus open nephroureterectomy for upper tract urothelial carcinoma: a propensity score matching analysis.","authors":"L. Afferi, M. Abufaraj, F. Soria, D. D’andrea, E. Xylinas, T. Seisen, M. Rouprêt, C. Lonati, A. De la taille, B. Peyronnet, E. Laukhtina, B. Pradère, A. Mari, W. Krajewski, M. Álvarez-Maestro, E. Kikuchi, K. Shigeta, P. Chłosta, F. Montorsi, A. Briganti, G. Simone, P. Ornaghi, M. Cerruto, A. Antonelli, Kazumasa Matsumoto, P. Karakiewicz, L. Mordasini, A. Mattei, S. Shariat, M. Moschini","doi":"10.23736/S0393-2249.20.04127-2","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04127-2","url":null,"abstract":"BACKGROUND\u0000Radical nephroureterectomy (RNU) with the concomitant excision of the distal ureter and bladder cuff is the current standard of care for the treatment of muscle invasive and/or high-risk upper tract urothelial carcinoma (UTUC). In small uncontrolled studies, laparoscopic RNU has been suggested to be associated with better perioperative outcomes compared to open RNU. The aim of our study was to compare the perioperative oncological and functional outcomes of open RNU versus laparoscopic RNU after adjusting for preoperative baseline patient-related characteristics.\u0000\u0000\u0000METHODS\u0000We evaluated a multi institutional retrospective database composed by 1512 patients diagnosed with UTUC and treated with open or laparoscopic RNU between 1990 and 2016. Perioperative outcomes included operative time, blood loss, and length of hospital stay, as well as postoperative complications, readmission, reoperation, and mortality rates at 30 and 90 days from surgery. A 1:1 propensity score matching estimated using logistic regression with the teffects psmatch function of STATA 13® (caliper 0.2, no replacement) was performed using preoperative parameters such as: age, gender, body mass index (BMI), and American Society of Anesthesiologists (ASA) score.\u0000\u0000\u0000RESULTS\u0000Overall, 1007 (66.6%) patients were treated with open and 505 (33.4%) with laparoscopic RNU. Open RNU resulted into shorter median operative time (180 vs 230 min, p<0.001) and longer median hospital stay (10 vs 7 days, p<0.001) in comparison to laparoscopic RNU. No statistically significant difference was identified for the other variables of interest (all p>0.05). At multivariable linear regression after propensity score matching adjusted for lymph node dissection and year of surgery, laparoscopic RNU resulted in longer operative time (Coefficient 43.6, 95% CI 27.9-59.3, p<0.001) and shorter hospital stay (Coefficient -1.27, 95% CI -2.1 to -0.3, p=0.01) compared to open RNU, but the risk of other perioperative complications remained similar between the two treatments.\u0000\u0000\u0000CONCLUSIONS\u0000Laparoscopic RNU is associated with shorter hospital stay, but longer operative time in comparison to open RNU. Otherwise, there were no differences in other perioperative outcomes between these surgical modalities even after propensity score matching. The choice to offer laparoscopic or open RNU in the treatment of UTUC should not be based on concerns of different safety outcomes.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77005247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of statin use and oncological outcomes in patients with first diagnosis of T1 high grade non-muscle invasive urothelial bladder cancer: results from a multicentre study.","authors":"M. Ferro, M. Marchioni, G. Lucarelli, V. M. Dorin, F. Soria, D. Terracciano, F. Mistretta, S. Luzzago, C. Buonerba, F. Cantiello, A. Mari, A. Minervini, A. Veccia, A. Antonelli, G. Musi, R. Hurle, G. Busetto, F. del Giudice, B. Chung, F. Berardinelli, S. Perdoná, P. Del Prete, V. Mirone, M. Borghesi, A. Porreca, P. Bove, R. Autorino, N. Crisan, A. R. Abu Farhan, M. Battaglia, P. Ditonno, G. Russo, M. Muto, R. Damiano, M. Manfredi, F. Porpiglia, O. de Cobelli, L. Schips","doi":"10.23736/S0393-2249.20.04076-X","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04076-X","url":null,"abstract":"INTRODUCTION\u0000We aimed to test the hypothesis that the immune-modulatory effect of statins may improve survival outcomes in patients with non-muscle invasive bladder cancer (NMIBC). We focused on a cohort of patients diagnosed with high risk NMIBC, that were treated with intravesical BCG immunotherapy.\u0000\u0000\u0000PATIENTS AND METHODS\u0000We included patients at first diagnosis of T1 high grade NMIBC after transurethral resection of bladder (TURB). All procedures were performed at 18 different tertiary institutions between January 2002 and December 2012. Univariable and multivariable models were used to test differences in terms of residual tumour, disease recurrence, disease progression and overall mortality (OM) rates.\u0000\u0000\u0000RESULTS\u0000Overall, 1510 patients with T1 high grade NMIBC at TURB were included in our analyses. Of these, 402 (26.6%) were statin users. At multivariable analysis, statin use was associated with a higher rates of high grade BC at re-TURB (OR: 1.37, 95%CI: 1.04-1.78; p=0.022), while at follow-up it was not independently associated with OM (HR: 0.71, 95%CI: 0.50-1.03; p=0.068) and disease progression rates (HR: 0.97, 95%CI: 0.79-1.19; p=0.753). Conversely, statin use has been shown to be independently associated with a lower risk of recurrence (HR:0.80, 95%CI: 0.67-0.95; p=0.009). The median recurrence-free survival was 47 (95%CI 40-49) months for those classified as non-statin users vs. 53 (95%CI 48-68) months in those classified as statin users.\u0000\u0000\u0000CONCLUSIONS\u0000Statin daily intake do not compromise oncological outcomes in high risk NMIBC patients treated with BCG. Moreover, statin may have a beneficial effect on recurrence rates in this cohort of patients.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82515217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related quality of life 24-month after prostate cancer diagnosis: an update from the Pros-IT CNR prospective observational study.","authors":"C. Palumbo, A. Bruni, A. Antonelli, W. Artibani, P. Bassi, F. Bertoni, P. Borghetti, S. Bracarda, A. Cicchetti, R. Corvò, M. Gacci, G. Ingrosso, S. Magrini, M. Maruzzo, V. Mirone, R. Montironi, G. Muto, M. Noale, A. Porreca, E. Russi, L. Triggiani, A. Tubaro, R. Valdagni, S. Maggi, G. Conti","doi":"10.23736/S0393-2249.20.04032-1","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04032-1","url":null,"abstract":"BACKGROUND\u0000This study analyzes patient health-related quality of life (QoL) 24-month after prostate cancer (PCa) diagnosis within the PROState cancer monitoring in ITaly from the National Research Council (Pros-IT CNR) study.\u0000\u0000\u0000METHODS\u0000Pros-IT CNR is an ongoing, longitudinal and observational study, considering a convenience sample of patients enrolled at PCa diagnosis and followed at 6, 12, 24, 36, 48 and 60 months from the diagnosis. Patients were grouped according to the treatment received: nerve sparing radical prostatectomy (NSRP), non-nerve sparing radical prostatectomy (NNSRP), radiotherapy (RT), radiotherapy plus androgen deprivation (RT plus ADT) and active surveillance (AS). QoL was measured through the Italian versions of SF-12 and UCLA-PCI questionnaires at diagnosis and at 6-12 and 24-month. The minimal clinically important difference (MCID) was defined as half a standard deviation of the baseline domain.\u0000\u0000\u0000RESULTS\u0000Overall, 1 537 patients were included in the study. The decline in urinary function exceeded the MCID at each timepoint only in the NSRP and NNSRP groups (at 24 months -14.7, p<0.001 and - 19.7, p<0.001, respectively). The decline in bowel function exceeded the MCID only in the RT (-9.1, p=0.02) and RT plus ADT groups at 12 months (-10.3, p=0.001); after 24 months, most patients seem to recover their bowel complaints. The decline in sexual function exceeded the MCID at each timepoint in the NNSRP, NSRP and RT plus ADT groups (at 6 months -28.7, p<0.001, -37.8, p<0.001, -20.4, p<0.001, respectively).\u0000\u0000\u0000CONCLUSIONS\u0000Although all the treatments were relatively well-tolerated over the 24 month period following PCa diagnosis, each had a different impact on QoL.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79900112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous ureteral stone passage: a novel and comprehensive nomogram.","authors":"Nassib F. Abou Heidar, Muhieddine Labban, Jad A. Najdi, Anwar Al Shami, Oussama G. Nasrallah, R. Nasr","doi":"10.23736/S0393-2249.20.04125-9","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04125-9","url":null,"abstract":"BACKGROUND\u0000Ureteral stones pose a high economic and medical burden among Emergency Department (ED) admissions. Management strategies vary from expectant therapy to surgical interventions. Since predictors of ureteral spontaneous stone passage (SSP) are still not well understood, we sought to create a novel nomogram to guide management decisions.\u0000\u0000\u0000METHODS\u0000Charts were retrospectively reviewed for patients who presented to our institution's ED with non-febrile renal colic and received a radiological diagnosis of ureteral stone ≤10 mm. Demographic, clinical, laboratory, and non-contrast CT data were collected. This novel nomogram incorporates the serum neutrophil-to-lymphocyte ratio (NLR) as a potential predictor of SSP. The model was derived from a multivariate logistic regression and was validated on a different cohort. A receiver operator characteristic (ROC) curve was constructed and the area under the curve (AUC) was computed.\u0000\u0000\u0000RESULTS\u0000A total of 1186 patients presented to our ED between January 2010 and October 2018. We randomly divided our population into a derivation and validation cohort in one to five ratio. A stone size ≥ 7 mm was the strongest predictor of SSP failure; OR=9.47; 95%CI (6.03-14.88). Similarly, a NLR ≥ 3.14 had 2.17; (1.58-2.98) the odds of retained stone. SSP failure was also correlated with proximal position, severe hydronephrosis, and leukocyte esterase ≥ 75, p=0.02, p=0.05, and p=0.006, respectively. The model had an AUC of 0.804 (0.776-0.832). The nomogram was also used to compute the risk of SSP failure (AUC 0.769 (0.709 - 0.829).\u0000\u0000\u0000CONCLUSIONS\u0000Our novel nomogram can be used as a predictor for SSP and can be used clinically in decision making.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79194821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Molecular biomarkers in the context of focal therapy for prostate cancer: recommendations of a Delphi Consensus from the Focal Therapy Society.","authors":"G. Marra, M. P. Laguna, J. Walz, C. Pavlovich, F. Bianco, J. Gregg, A. Lebastchi, H. Lepor, P. Macek, S. Rais-Bahrami, C. Robertson, D. Rukstalis, G. Salomon, O. Ukimura, A. Abreu, Y. Barbe, X. Cathelineau, G. Gandaglia, A. George, J. Rivas, Rajan T Gupta, N. Lawrentschuk, V. Kasivisvanathan, D. Lomas, B. Malavaud, D. Margolis, Y. Matsuoka, S. Mehralivand, M. Moschini, M. Oderda, H. Orabi, A. Rastinehad, M. Remzi, A. Schulman, T. Shin, T. Shiraishi, A. Sidana, S. Shoji, A. Stabile, M. Valerio, V. Tammisetti, Wei Phin Tan*, W. van den Bos, A. Villers, Peter Willemse, J. J. de la Rosette, T. Polascik, R. Sanchez-Salas","doi":"10.23736/S0393-2249.20.04160-0","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.04160-0","url":null,"abstract":"BACKGROUND\u0000Focal Therapy (FT) for Prostate Cancer (PCa) is promising. However, long-term oncological results are awaited and there is no consensus on follow-up strategies. Molecular biomarkers (MB) may be useful in selecting, treating and following up men undergoing FT, though there is limited evidence in this field to guide practice. We aimed to conduct a consensus meeting, endorsed by the Focal Therapy Society, amongst a large group of experts, to understand the potential utility of MB in FT for localised PCa.\u0000\u0000\u0000MATERIALS AND METHODS\u0000A 38-item questionnaire was built following a literature search. The authors then performed three rounds of a Delphi Consensus using DelphiManager, using the GRADE grid scoring system, followed by a face-to-face expert meeting. Three areas of interest were identified and covered concerning MB for FT, i) the current/present role; ii) the potential/future role; iii) the recommended features for future studies. Consensus was defined using a 70% agreement threshold.\u0000\u0000\u0000RESULTS\u0000Of 95 invited experts, 42 (44.2%) completed the three Delphi rounds. Twenty-four items reached a consensus and they were then approved at the meeting involving (n=15) experts. Fourteen items reached a consensus on uncertainty, or they did not reach a consensus. They were re-discussed, resulting in a consensus (n=3), a consensus on a partial agreement (n=1), and a consensus on uncertainty (n=10). A final list of statements were derived from the approved and discussed items, with the addition of three generated statements, to provide guidance regarding MB in the context of FT for localised PCa. Research efforts in this field should be considered a priority.\u0000\u0000\u0000CONCLUSIONS\u0000The present study detailed an initial consensus on the use of MB in FT for PCa. This is until evidence becomes available on the subject.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73540314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}