Minerva Urologica E Nefrologica最新文献

{"title":"Conservative management of urinary incontinence following robot-assisted radical prostatectomy.","authors":"Michele Marchioni,&nbsp;Giulia Primiceri,&nbsp;Pietro Castellan,&nbsp;Luigi Schips,&nbsp;Guglielmo Mantica,&nbsp;Christopher Chapple,&nbsp;Rocco Papalia,&nbsp;Francesco Porpiglia,&nbsp;Roberto M Scarpa,&nbsp;Francesco Esperto","doi":"10.23736/S0393-2249.20.03782-0","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03782-0","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic assisted radical prostatectomy (RARP) is getting more and more popular becoming the most common radical prostatectomy technique. Unfortunately, a not negligible proportion of patients in whom RARP is performed experience urinary incontinence. We aimed to systematically review the current literature evidence on urinary incontinence conservative treatment after RARP.</p><p><strong>Edidence aquisition: </strong>A systematic literature review search using PubMed (Medline), Scopus, and Web of Science databases was performed in December 2019. PRISMA guidelines have been adopted. Population consisted of patients with urinary incontinence after RARP (P), conservative intervention was considered of interest (I). No comparator was considered mandatory (C). Outcomes of interest were the recovery of continence and quality of life (O).</p><p><strong>Evidedence synthesis: </strong>Six studies were included. Four of them investigated the use of pelvic floor muscle training (PFMT). PFMT improved pelvic muscle strength. Continence recovery was faster when guided PFMT was adopted. Moreover, two studies tested the effect of solifenacin on urinary incontinence. One of them, a randomized clinical trial, failed to show shorter time to continence in solifenacin group compared to placebo.</p><p><strong>Conclusions: </strong>The use of pads is associated with a detrimental effect on quality of life thus active treatments for UI post-RARP are warranted. PFMT has the main advantage to shorten the time for recovery. The use of solifenacin seems to not offer striking advantages in UI following RARP. Future studies should focus on testing the efficacy of these treatments when used after robotic vs. open radical prostatectomy.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"555-562"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37955490","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":"Robot-assisted radical cystectomy with intracorporeal neobladder: impact of learning curve and long-term assessment of functional outcomes.","authors":"G. Tuderti, R. Mastroianni, A. Brassetti, A. Bove, L. Misuraca, U. Anceschi, M. Ferriero, M. Gallucci, G. Simone","doi":"10.23736/S0393-2249.20.03948-X","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03948-X","url":null,"abstract":"BACKGROUND\u0000There is paucity of data about functional outcomes of Robot-assisted Radical Cystectomy (RARC) with intracorporeal orhotopic neobladder (ICON), and the impact of learning curve (LC) on those outcomes remains to be addressed. We aimed to report long-term functional outcomes of our single center series of RARC with ICON, assessing the role of LC in their achievement.\u0000\u0000\u0000METHODS\u0000Patients treated with Robot assisted radical cystectomy with intracorporeal orthotopic neobladder in our center between January 2012 an August 2019 were retrospectively analysed. Preoperative, clinical, perioperative, pathologic and functional data were reported. The first cases were divided in tertiles, for assessing the impact of learning curve on the outcomes evaluated. Long-term functional outcomes of the whole cohort were evaluated.\u0000\u0000\u0000RESULTS\u0000Overall, 167 patients were included. Concerning tertiles analysis, operative time (p<0.001), incidence of low (p=0.002) and high grade (p=0.001) complications and hospital stay (p=0.04) decreased significantly over time. Day-time continence recovery probability was significantly lower in the initial case series (1-yr rate 68.4%, 87% and 89.8 for I, II and III tertile, respectively; p=0.04;). Accordingly, Trifecta achievement was significantly higher in II and III tertiles (p=0.01). At a median follow- up of 34 months, the incidence of significant renal function deterioration of the whole cohort was 16.7%. Overall, 12, 24 and 60-mo day-time continence rates were 74.8 %, 82.7 % and 82.7 %.\u0000\u0000\u0000CONCLUSIONS\u0000Patients treated at the beginning of the learning curve show worse perioperative and functional results. Once standardized the procedure, complications rates, hospital stay and daytime continence recovery experienced a significant improvement. At a long-term analysis of functional outcomes of our patients, renal function preservation and continence recovery results are encouraging.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75831315","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 multiple abbreviated multiparametric MRI-derived protocols for the detection of clinically significant prostate cancer.","authors":"L. Cereser, G. Giannarini, Filippo Bonato, S. Pizzolitto, G. Como, C. Valotto, V. Ficarra, F. Dal Moro, C. Zuiani, R. Girometti","doi":"10.23736/S0393-2249.20.03952-1","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03952-1","url":null,"abstract":"BACKGROUND\u0000To compare the accuracy of multiple abbreviated multiparametric magnetic resonance imaging (mpMRI)-derived protocols in detecting clinically significant prostate cancer (csPCa).\u0000\u0000\u0000METHODS\u0000108 men undergoing staging 3.0T mpMRI with a Prostate Imaging - Reporting and Data System version 2 (PI-RADSv2)-compliant protocol before radical prostatectomy (RP) were retrospectively evaluated. Two readers (R1, R2) independently analyzed mpMRI, assigning a PI-RADSv2 category to each observation as appearing on each examination sequence. A study coordinator assessed final PI-RADSv2 category by combining readers' assignments according to four protocols: short MRI (sMRI) (diffusion-weighted imaging + axial T2-weighted imaging), contrast-enhanced short MRI (cesMRI) (sMRI + dynamic contrast-enhanced [DCE] imaging), biparametric MRI (diffusion-weighted imaging + multiplanar T2-weigthed imaging), and mpMRI. Using RP pathology as the reference standard for csPCa, we calculated the per-lesion cancer detection rate (CDR) and false discovery rate (FDR) for each MRI protocol (cutoff PI-RADSv2 category ≥3), and the per-PI-RADSv2 category prevalence of csPCa and false positives.\u0000\u0000\u0000RESULTS\u0000Pathology after RP found 142 csPCas with median International Society of Urogenital Pathology grade group 2, and stage ≤pT2c in 68.6% of cases. CDR was comparable across the four MRI protocols (74.6% to 75.3% for R1, and 68.3% for R2). FDR was comparable as well (14.4%-14.5% for R1 and 11.1% for R2). sMRI was the minimum protocol equaling mpMRI in terms of CDR, although cesMRI, similarly to mpMRI, was associated with fewer PI-RADSv2 category 3 assignments and higher prevalence of csPCa within PI-RADSv2 category 3 observations (66.7% versus 76.9% for R1, and 100% versus 91.7% for R2, respectively).\u0000\u0000\u0000CONCLUSIONS\u0000Among multiple abbreviated mpMRI-derived protocols, cesMRI was the one equaling mpMRI in terms of csPCa detection and minimizing PI-RADSv2 category 3 assignments.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87118747","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":"Laparoscopic radical cystectomy with extracorporeal urinary diversion: an Italian single-center experience with 10-year outcomes.","authors":"Maida Bada,&nbsp;Bernardino De Concilio,&nbsp;Felice Crocetto,&nbsp;Massimiliano Creta,&nbsp;Tommaso Silvestri,&nbsp;Marina Di Mauro,&nbsp;Antonio Celia","doi":"10.23736/S0393-2249.20.03850-3","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03850-3","url":null,"abstract":"","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"641-643"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054768","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":"The role of additional standard biopsy in the MRI-targeted biopsy era.","authors":"Enrico Checcucci,&nbsp;Sabrina De Cillis,&nbsp;Federico Piramide,&nbsp;Daniele Amparore,&nbsp;Veeru Kasivisvanathan,&nbsp;Francesco Giganti,&nbsp;Cristian Fiori,&nbsp;Caroline M Moore,&nbsp;Francesco Porpiglia","doi":"10.23736/S0393-2249.20.03958-2","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03958-2","url":null,"abstract":"","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"637-639"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38007318","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":"Intracorporeal versus extracorporeal urinary diversion after robotic-assisted radical cystectomy: evidence from a systematic review and pooled analysis of observational studies.","authors":"Dechao Feng,&nbsp;Yin Tang,&nbsp;Yubo Yang,&nbsp;Ping Han,&nbsp;Wuran Wei","doi":"10.23736/S0393-2249.20.03829-1","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03829-1","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to compare the perioperative, pathological and oncological outcomes of patients undergoing extracorporeal urinary diversion (EUD) and intracorporeal urinary diversion (IUD) following robot-assisted radical cystectomy (RARC).</p><p><strong>Evidence acquisition: </strong>Multiple scientific databases were searched up to January 2020 for comparative studies comparing IUD and EUD. The data was analyzed by Review Manager 5.3.</p><p><strong>Evidence synthesis: </strong>A total of 9 observational studies comprising 3582 patients were included in the final analysis. We observed that IUD approach were significantly associated with lower estimated blood loss (EBL) (MD: -90.50, 95% CI: -131.26 to -49.74, P<0.0001), fewer gastrointestinal complications (RR: 0.65; 95% CI: 0.45 to 0.93; P=0.02), and lower risk of uretero-ileal anastomotic stricture (RR: 0.36; 95% CI: 0.14 to 0.91; P=0.03). We did not detect significant difference in terms of length of stay (P=0.14), operative time (P=0.55), blood transfusion (P=0.10), 30-day complication (P=0.50), 90-day complication (P=0.40), 30-day readmission (P=0.12), 90-day readmission (P=0.95), positive surgical margins (P=0.42), lymph node yield (P=0.13), 30-day reoperation (P=0.11) and 90-day mortality (0.27) between IUD and EUD.</p><p><strong>Conclusions: </strong>The approach of urinary diversion does not have a considerable impact on pathological, perioperative and oncological outcomes in patients undergoing RARC. The benefits conferred by IUD are lower EBL, lower risk of gastrointestinal complications, and uretero-ileal anastomotic stricture. Subgroup analysis of patients with ileal conduit showed similar results on perioperative and complication outcomes. Well-designed trials conducted by large volumes and experienced surgeons, and reporting complications based on standardized methodology are still warranted.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"519-530"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054767","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":"Metastasis-directed therapy and prostate-targeted therapy in oligometastatic prostate cancer: a systematic review.","authors":"Noriyoshi Miura,&nbsp;Benjamin Pradere,&nbsp;Keiichiro Mori,&nbsp;Hadi Mostafaei,&nbsp;Fahad Quhal,&nbsp;Vincent Misrai,&nbsp;David D'Andrea,&nbsp;Simone Albisinni,&nbsp;Rocco Papalia,&nbsp;Takashi Saika,&nbsp;Roberto M Scarpa,&nbsp;Shahrokh F Shariat,&nbsp;Francesco Esperto","doi":"10.23736/S0393-2249.20.03779-0","DOIUrl":"10.23736/S0393-2249.20.03779-0","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this review was to summarize the available evidence on the role of metastasis-directed therapy (MDT) and/or prostate-targeted therapy (PTT) in the setting of oligometastatic prostate cancer (PCa).</p><p><strong>Evidence acquisition: </strong>We searched PubMed, the Web of Science, and the Cochrane Library databases. The following keywords were used: (\"prostate cancer\" OR \"prostate carcinoma\" OR \"prostate neoplasm\" OR \"prostate tumor\") AND (\"oligometastatic\" OR \"oligometastasis\" OR \"PSMA\") AND (\"surgery\" OR \"prostatectomy\" OR \"radical prostatectomy\" OR \"cytoreductive\" OR \"local treatment\" OR \"radiotherapy\" OR \"stereotactic\" OR \"stereotaxic\") AND (\"survival\" OR \"mortality\").</p><p><strong>Evidence synthesis: </strong>After evaluating the selection criteria, 81 studies were evaluated for our endpoints. We included 22 studies for PTT of synchronous mPCa. There have been no randomized studies on cytoreductive prostatectomy (cRP). Four prospective studies showed that cRP was feasible but did not contribute to a positive effect on overall survival (OS). Regarding PTT-radiotherapy, two randomized controlled phase 3 trials showed that OS was improved in men with a low metastatic burden. Regarding MDT of metachronous lymph node recurrence, we included 29 retrospective studies. For MDT of oligometastases, we included 30 studies. One randomized phase 2 trial showed that androgen deprivation therapy-free survival improved with stereotactic body radiation therapy compared to that with surveillance; however, benefits on OS remain unclear.</p><p><strong>Conclusions: </strong>We performed a comprehensive overview of the current literature on MDT and PTT. The feasibility of MDT and PTT is supported by several retrospective studies. Nevertheless, there remains a lack of high-quality trials to prove its survival benefits. Results from ongoing prospective trials data are awaited.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"531-542"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38054766","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":"Efficacy and safety of the tranexamic acid in reducing blood loss and transfusion requirements during percutaneous nephrolithotomy: a systematic review and meta-analysis of randomized controlled trials.","authors":"Dechao Feng,&nbsp;Fan Zhang,&nbsp;Shengzhuo Liu,&nbsp;Ping Han,&nbsp;Wuran Wei","doi":"10.23736/S0393-2249.20.03826-6","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03826-6","url":null,"abstract":"<p><strong>Introduction: </strong>Percutaneous nephrolithotomy (PCNL) is a minimally invasive approach used for large kidney stones. Although tranexamic acid (TA) has the property of reducing perioperative bleeding, the effect of this drug on PCNL is equivocal. This meta-analysis was conducted to determine the efficacy and safety of TA in preventing hemorrhagic complications, transfusion requirements and other perioperative outcomes during PCNL with available randomized-controlled trials (RCTs).</p><p><strong>Evidence acquisition: </strong>We performed a systematic review of the literature according to Cochrane guidelines for studies comparing TA and normal saline. All studies reporting the outcomes of interest were included. The data analysis was completed using the Cochrane Collaboration's software RevMan 5.3.</p><p><strong>Evidence synthesis: </strong>Data from three RCTs on 570 patients were included in the final meta-analysis. Patients receiving TA experienced less blood loss (MD: -0.82; 95% CI: -1.24 to -0.40; P=0.0001), fewer transfusion requirements (OR: 0.40; 95% CI: 0.01-0.76; P=0.005), lower minor complication rate (OR:0.51, 95% CI: 0.32-0.80, P=0.003), fewer major complication rate (OR:0.31, 95% CI: 0.11-0.88, p=0.03), shorter operative time (SMD: -0.39; 95% CI: -0.75 to -0.02; P=0.04) and less length of stay (LOS) (SMD: -0.68; 95% CI: -1.01 to -0.35; P<0.0001) than their counterparts during PCNL with statistically significant P value and no significant between-study heterogeneity except for LOS and operative time.</p><p><strong>Conclusions: </strong>Our work assessing the use of TA in the clinical management of patients undergoing PCNL indicated promising results. Further well-designed trials are warranted to determine the optimal dose and indications of this drug in practice.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"579-585"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38074324","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":"Retzius-sparing robot-assisted radical prostatectomy versus open retropubic radical prostatectomy: a prospective comparative study with 19-month follow-up.","authors":"Ali Abdel Raheem,&nbsp;Ayman Hagras,&nbsp;Ahmed Ghaith,&nbsp;Mohamed J Alenzi,&nbsp;Ahmed Elghiaty,&nbsp;Tarek Gameel,&nbsp;Ibrahim Alowidah,&nbsp;Won S Ham,&nbsp;Young D Choi,&nbsp;Abdel H El-Bahnasy,&nbsp;Adel Omar,&nbsp;Mohamed El-Bendary,&nbsp;Koon H Rha","doi":"10.23736/S0393-2249.20.03830-8","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03830-8","url":null,"abstract":"<p><strong>Background: </strong>The aim of the present study was to compare the surgical outcomes of retzius-sparing robot-assisted radical prostatectomy (RS-RARP) and open retropubic radical prostatectomy (ORP).</p><p><strong>Methods: </strong>We included patients with clinically localized prostate cancer who underwent RS-RARP or ORP and met our inclusion criteria. We compared the perioperative, oncological, and continence outcomes between both surgical approaches. Continence function was assessed using the validated International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Continence was defined as using 0-1 safety pad per day. Biochemical recurrence (BCR) was defined as two consecutive rises in serum PSA more than 0.2 ng/mL. Events of local recurrence, distant metastasis, and cancer death were reported and compared using Kaplan-Meier survival analysis.</p><p><strong>Results: </strong>Between 1 June 2013 and 1 October 1 2016, 184 men were enrolled, of whom 125 underwent RS-RARP and 59 underwent ORP. Baseline demographic and pathological characteristics were similar between both groups (P>0.05). Patients in RS-RARP group had significantly lower blood loss, fewer transfusion rates, lower VAS score, and shorter hospital stay than patients in ORP group (P<0.05). Major complications (≥grade 3b) did not differ between both groups (P=0.121). Positive surgical margins were 28.8% and 24.8% in ORP and RS-RARP, respectively (P=0.494). The BCR free-survival rates in ORP and RS-RARP at 1-year was 87.3% and 92.3%, respectively (Log-rank, P=0.740). At 1-, 6-, and 12-month after surgery, 42.4%, 79.7%, and 84.7% of men undergoing ORP were continent, compared with 72.8%, 90.4%, and 92% undergoing RS-RARP, respectively. Men in RS-RARP group achieved faster recovery of urinary continence compared to men in ORP group (Log-rank, P=0.001).</p><p><strong>Conclusions: </strong>RS-RARP had better perioperative outcomes and faster recovery of urinary continence compared with ORP. Short-term oncological outcomes were comparable between both surgical approaches.</p>","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":" ","pages":"586-594"},"PeriodicalIF":0.0,"publicationDate":"2020-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38233475","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":"Prognostic value of preoperative albumin to globulin ratio in patients treated with salvage radical prostatectomy for radiation recurrent prostate cancer.","authors":"F. Quhal, B. Pradère, R. Sari Motlagh, K. Mori, E. Laukhtina, A. Aydh, H. Mostafaei, I. Lysenko, V. Schuettfort, F. Stolzenbach, C. Palumbo, A. Heidenreich, A. Briganti, P. Karakiewicz, P. Chłosta, S. Shariat","doi":"10.23736/S0393-2249.20.03938-7","DOIUrl":"https://doi.org/10.23736/S0393-2249.20.03938-7","url":null,"abstract":"BACKGROUND\u0000Serum albumin-to-globulin ratio (AGR) has been shown to be associated with poor prognosis in different malignancies. In this study we aimed to evaluate the predictive value of preoperative AGR for oncological outcomes in patients with radiation recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP).\u0000\u0000\u0000METHODS\u0000A retrospective review of 214 consecutive patients with radiation-recurrent PCa who underwent SRP at five referral centers. Levels of albumin and globulin were obtained before SRP and used to calculate the preoperative AGR level. The optimal cut off value of preoperative AGR was 1.4. Univariable and multivariable Cox regression analyses were performed.\u0000\u0000\u0000RESULTS\u0000Overall 89 (41.6%) patients had a low preoperative AGR. Low serum AGR was associated with biochemical recurrence (BCR) in univariable Cox regression analysis (HR 1.60, 95%CI 1.06-2.43, P=0.026). When adjusted for the effects of established preoperative and postoperative clinicopathologic confounders in different multivariable Cox regression models, this association did not retain its statistical significance. Moreover, preoperative AGR was not associated with metastasis free survival (P= 0.21), overall survival (P= 0.91) or cancer specific survival (P=0.61).\u0000\u0000\u0000CONCLUSIONS\u0000In patients with radiation recurrent PCa undergoing SRP, low preoperative AGR was associated with the risk of BCR only in univariable analysis. There was no association with metastasis or survival outcomes. Further studies are needed to evaluate this biomarker in the setting of primary PCa and to identify the patients most likely to benefit from a local therapy.","PeriodicalId":49015,"journal":{"name":"Minerva Urologica E Nefrologica","volume":"s3-32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90823164","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}