Publications by authors named "Carrieri G"
Purpose: This study aimed to comprehensively evaluate the prognostic value of T1 histo-anatomic substaging (T1a/T1b) for high grade (HG) non-muscle invasive bladder cancer (NMIBC) over a large single-centre cohort.
Materials And Methods: Patients with primary HG T1 NMIBC were identified from our Institutional database, between 2011 and 2022. Data from diagnosis to repeated transurethral resection of bladder tumour (RE-TURBT), bacillus Calmette-Guérin (BCG) treatment and follow-up were collected.
Background: Previous studies found that Midlife Baseline PSA (MB PSA) predicts the risk of developing lethal prostate cancer (PCa), although the cohorts were homogenous in terms of racial compositions. We aimed to investigate racial disparities in the predictive value of MB PSA for lethal PCa in a diverse, contemporary, North American population.
Methods: Our cohort included White and Black men aged 40-59 years, who underwent MB PSA through our health system.
Article Synopsis
- Circulating tumor DNA (ctDNA) testing is highlighted as a valuable tool for prognosis and treatment guidance in urological tumors, providing insights into disease progression and drug resistance.
- A literature review showed that ctDNA levels increase from localized to metastatic disease in prostate and urothelial cancers, suggesting its potential in risk stratification and treatment choices.
- Although ctDNA analysis has promising implications for clinical management, further research, particularly in renal cell carcinoma, is needed to fully integrate it into routine practice through a collaborative approach among various specialists.
Article Synopsis
- About 70% of bladder cancer cases are non-muscle invasive (NMIBC) and inflammation, influenced by factors like smoking, affects treatment outcomes with BCG therapy.
- A study analyzed data from 1,313 NMIBC patients to examine how smoking and systemic inflammation impact the effectiveness of BCG using a machine-learning algorithm.
- The results indicated that both smoking status and specific inflammatory markers can significantly predict the risk of disease progression, highlighting the need for tailored treatment strategies and further research to confirm the findings.
Purpose: To assess active surveillance (AS) adherence for prostate cancer (PCa) in a "real-world" clinical practice.
Materials And Methods: We utilized our institutional database which was built by interrogating electronic medical records for all men who got diagnosed with PCa from 1995 to 2022. Our cohort included all patients aged < 76 years, with PCa Gleason Grade (GG) 1 or 2, ≤ cT2c, PSA ≤ 20 ng/ml at diagnosis, enrolled on AS, and with at least one biopsy after diagnosis.
Article Synopsis
- Socio-economic and demographic factors impact prostate cancer (PCa) outcomes, particularly through area deprivation index (ADI) and race in a North-American cohort study.
- The study followed 134,366 men who had at least one PSA test from 1995 to 2022, categorizing them based on ADI scores tied to their residential areas and analyzing PCa incidence and lethality across different racial groups.
- Results indicated that men in more deprived areas had lower overall PCa incidence but higher lethality; however, Black men experienced increased incidence and worse outcomes compared to White men across all deprivation levels.
Article Synopsis
- This study evaluated cancer control outcomes in prostate cancer patients with clinically positive nodal involvement, comparing surgery with radiation while considering other causes of death.
- Researchers analyzed data from the SEER database for patients diagnosed from 2004 to 2017, using advanced statistical methods to adjust for differences in treatment and mortality risk.
- Findings indicated that, after 10 years, patients treated with radiation had significantly higher cancer-specific mortality rates (27.6%) compared to those treated with surgery (18.1%), highlighting the advantages of surgical intervention.
Article Synopsis
- Non-Hispanic Black (NHB) men have a higher risk of prostate cancer (PCa) incidence and mortality than Non-Hispanic White (NHW) men, but this study focuses on incidental PCa cases from two North American cohorts.
- The research analyzed data from SEER (2004-2017) and Henry Ford Health (1995-2022) to compare cancer-specific mortality (CSM) and management of incidental PCa between NHB and NHW men, finding no major pathological differences except for slightly elevated PSA levels in NHB men.
- Conclusions indicate that both groups had similar survival outcomes, challenging previous beliefs that racial disparities significantly affect prostate cancer mortality after incidental diagnoses.
Article Synopsis
- - The study investigates the effectiveness of midlife baseline prostate-specific antigen (MB PSA) compared to PSA doubling time (PSADT) and PSA velocity (PSAV) in predicting the risk of developing lethal prostate cancer in men aged 40-59.
- - A total of 77,594 men with at least two PSA tests and 11,634 men with three tests were analyzed, with data gathered from 1995 to 2019 to determine the occurrence of lethal prostate cancer diagnoses.
- - Results showed significant associations of both MB PSA and PSADT with lethal prostate cancer risk, indicating that those in the top 10th percentile for MB PSA had a 6.10 times higher hazard of developing lethal cancer while those
Background: Voluntary PCa screening frequently results in excessive use of unnecessary diagnostic tests and an increasing risk of detection of indolent PCa and unaffordable costs for the various national health systems. In this scenario, the Italian Society of Urology (Società Italiana di Urologia, SIU) proposes an organized flow chart guiding physicians to improve early diagnosis of significant PCa avoiding unnecessary diagnostic tests and prostate biopsy.
Methods: According to available evidence and international guidelines [i.
To contrast opportunistic PCa screening, the European Union Council suggested extending screening programs to PCa by recommending the implementation of a stepwise approach in the EU Countries to evaluate the feasibility and effectiveness of an organized program based on PSA testing in combination with additional MRI as a follow-up test. The objective of this expert-based document is to propose an organized PCa screening program according to the EU Council recommendations. The Italian Society of Urology (SIU) developed a team of experts with the aim to report 1) the most recent epidemiologic data about incidence, prevalence, and mortality of PCa; 2) the most important risk factors to identify categories of men with an increased risk to eventually develop the disease; 3) the most relevant studies presenting data on population-based screening; and 4) the current recommendations of the leading International Guidelines.
View Article and Find Full Text PDFBackground And Objective: The preferable technique for orthotopic bladder substitution after radical cystectomy is debated. The aim of this study was to describe our technique of a stapled W-shaped ileal neobladder and assess the complications and functional results in 100 patients. treated from December 2009 to July 2022.
View Article and Find Full Text PDFBackground: Overactive bladder (OAB) is a chronic condition. This study was prompted by the need to fill the gap between medical treatment and advanced therapies allowing improvement in Quality of Life. The aim of the current study was to evaluate the association between treatment type (Ialuril; IBSA Farmaceutici, Lodi, Italy; in combination with antimuscarinic or alone after drop-out of antimuscarinic, relative to antimuscarinic alone treatment) and functional outcomes (number of micturitions, pelvic pain, urinary incontinence, nocturia, urgency).
View Article and Find Full Text PDFArticle Synopsis
- Studies show that patients receiving radiation therapy (RT) for prostate cancer (PCa) have a higher risk of dying from causes unrelated to cancer than those who have radical prostatectomy (RP), hinting at poorer overall health in RT patients.
- Using data from the SEER database, researchers matched RP and RT patients based on their risk of other-cause mortality (OCM) and analyzed the effects on cancer-specific mortality (CSM).
- Results indicate that for patients with unfavorable-intermediate and high-risk cancer, RP significantly reduced CSM rates compared to RT, while no difference was found in those with favorable-intermediate or low-risk disease.
Objective: Comparative effectiveness studies comparing trimodal therapy (TMT) to radical cystectomy (RC) are typically hindered by selection bias where TMT is usually reserved to patients with poor overall health status. We developed a novel approach by matching patients based on their calculated other-cause mortality (OCM) risk. Using this homogeneous cohort, we tested the impact of TMT vs RC on cancer-specific mortality (CSM).
View Article and Find Full Text PDFPurpose: Prostatic urethral lift has been an effective ejaculation sparing treatment for benign prostatic hypertrophy. The aim of this study was to evaluate the effect on male semen parameters.
Methods: Between July 2014 and January 2022, 20 young men with urinary symptoms of BPH, unresponsive to drug treatment and motivated to preserve ejaculation for eventual paternity, underwent UroLift.
Article Synopsis
- A study aimed to compare the effect of PSA screening on prostate cancer mortality between non-Hispanic Black (NHB) and non-Hispanic White (NHW) men, noting a lack of previous research on this topic.
- The cohort included 6,378 men with prostate cancer, analyzed based on their PSA testing frequency prior to diagnosis, which showed that NHW men had a higher rate of annual testing compared to NHB men.
- Results indicated that PSA screening significantly reduced the risk of prostate cancer-specific mortality for both racial groups, with the benefit of screening appearing to be independent of race.*
Article Synopsis
- The study aimed to investigate how baseline PSA levels in men aged 40-59 predict the risk of lethal prostate cancer, focusing on modern cohorts rather than those from the pre-PSA screening era.
- A total of 129,067 men were analyzed, with results showing that higher PSA levels (≥90th percentile) significantly increased the likelihood of developing lethal prostate cancer compared to those with lower levels, indicating a strong correlation.
- The findings revealed that even in younger age groups (40-44), men with high PSA levels faced greater risks, emphasizing the importance of early PSA testing in assessing prostate cancer risk.
Article Synopsis
- This study examined prostate cancer-specific mortality (PCSM) among Black and White men by analyzing their other-cause mortality (OCM) risk to better understand healthcare access disparities.
- Researchers used a large patient database from 2004 to 2009, matching Black and White men with similar OCM risks for comparison.
- The findings revealed that when accounting for OCM risk, Black and White patients had similar rates of PCSM, suggesting that race did not significantly influence cancer survival rates at the population level.
Article Synopsis
- - The 2022 fifth edition of the WHO classification for urogenital tumors updates the renal epithelial tumors section, recognizing new disease entities and refining nomenclature compared to the 2016 edition.
- - It emphasizes the significance of biological and molecular data, recommending the use of immunohistochemistry (IHC) to connect traditional morphological features with genetic information for accurate diagnosis.
- - The article discusses key immunohistochemical markers for newly recognized tumor entities, such as clear cell capillary renal cell tumor and eosinophilic solid and cystic renal cell carcinoma, highlighting their unique profiles and diagnostic challenges.
Bladder cancer (BC) is one of the most prevalent cancers worldwide. Non-muscle invasive bladder cancer (NMIBC), comprising the majority of initial BC presentations, requires accurate risk stratification for optimal management. This review explores the evolving role of programmed cell death ligand 1 (PD-L1) as a prognostic biomarker in NMIBC, with a particular focus on its implications in the context of Bacillus Calmette-Guérin (BCG) immunotherapy.
View Article and Find Full Text PDFEjaculation sparing of classic and minimally invasive surgical treatments of LUTS/BPH.
Prostate Cancer Prostatic Dis
April 2024
Background: The surgical landscape for Lower Urinary Tract Symptoms (LUTS) and Benign Prostatic Hyperplasia (BPH) has evolved with the introduction of Minimally Invasive Surgical Therapies (MISTs), recognizing the impact of sexual function on patients' well-being, and prioritizing ejaculation-sparing approaches.
Methods: This systematic review explored ejaculation sparing after classic endoscopic procedures and MISTs (iTind, Rezūm, Urolift, Aquablation, and TPLA) and a literature search yielded 41 studies.
Results: While all procedures demonstrated efficacy in improving LUTS/BPH symptoms (IPSS, QoL, Qmax), a subset of studies evaluated ejaculatory function.
Background And Objective: Percutaneous nephrolithotomy (PCNL) is the recommended treatment for large or complex renal stones. This study aims to evaluate the outcomes of mini PCNL in obese and nonobese patients and to compare the outcomes of mini and standard PCNL in the obese population.
Methods: We retrospectively reviewed our PCNL database to identify patients who had undergone mini (Amplatz sheath size 17.
Background: Three primary strategies for MRI-targeted biopsies (TB) are available: Cognitive TB (COG-TB), MRI-US Fusion TB (FUS-TB), and In Bore TB (IB-TB). Despite nearly a decade of practice, a consensus on the preferred approach is lacking, with previous studies showing comparable PCa detection rates among the three methods.
Methods: We conducted a search of PubMed, EMBASE, PubMed, Web of Science, and Scopus databases from 2014 to 2023, to identify studies comparing at least two of the three methods and reporting clinically significant PCa (csPCa) detection rates.
Purpose: We aimed to assess the appropriateness of ChatGPT in providing answers related to prostate cancer (PCa) screening, comparing GPT-3.5 and GPT-4.
Methods: A committee of five reviewers designed 30 questions related to PCa screening, categorized into three difficulty levels.