Publications by authors named "Cazzaniga W"

Introduction: Kidney transplant (KT) recipients are at an elevated risk of developing de novo cancers. However, penile (PeCa) and testis cancers have received limited attention in this setting.

Objective: To summarize the epidemiology, treatment options, and oncological outcomes of penile and testis cancer in KT recipients.

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The 2021 updated International Germ Cell Cancer Collaborative Group classification for seminomatous germ cell tumours confirmed and refined the original classification, introducing the notion that lactate dehydrogenase (LDH) elevation above 2.5 times the upper limit of normal separates the good-risk prognostic group into two distinct subgroups, with clearly inferior survival outcomes for the high-LDH subgroup. Validation of this prognostic factor has understandably opened the question of the optimal management for patients with high-LDH good-risk seminoma.

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Objectives: To reassess the role of primary retroperitoneal lymph node dissection (RPLND) in patients with marker-negative non-seminomatous germ cell tumour (NSGCT) clinical stage (CS) 2a, to explore results in patients with CS 2b and to evaluate surgical methods, recurrence, and adjuvant chemotherapy indications.

Materials And Methods: Data from 17 institutions were collected, comprising 305 men who underwent primary RPLND for CS 2 NSGCT. Regression analyses were conducted to predict histology in the RPLND specimen and disease-free survival (DFS).

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Background And Objective: The majority of small testicular masses (STMs) are benign and therefore radical orchidectomy (RO) may represent overtreatment. In appropriately selected patients, surveillance or testis-sparing surgery (TSS) is an alternative option to preserve testicular function. Since there are no clear guidelines, we aimed to develop consensus recommendations on the management of STMs.

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Infertility is a prevalent issue affecting many couples during their reproductive years, with a significant number facing challenges in conceiving despite regular unprotected intercourse. Male factor infertility (MFI) contributes significantly to these cases, with a significant proportion of men lacking an identifiable etiology. As such, a thorough assessment of MFI has become increasingly vital for personalized management.

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Article Synopsis
  • * While there were some differences, especially regarding treatment for specific stages of seminoma and nonseminoma, the overall agreement between the guidelines was strong.
  • * This comparison highlights the consistency in recommendations for managing testicular cancer across both organizations, despite some variations.
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Purpose: No consensus exists on the management of men with nonseminoma and viable nonteratomatous germ cell tumor in the postchemotherapy retroperitoneal lymph node dissection (pcRPLND) specimen after first-line chemotherapy. We analyzed surveillance versus different adjuvant chemotherapy regimens and the influence of time to pcRPLND on oncologic outcomes.

Methods: Data on 117 men treated with cisplatin-based first-line chemotherapy between 1990 and 2018 were collected from 13 institutions.

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Prostate cancer, the most common cause of cancer in men in the UK and one of the most common around the world to date, has no consensus on screening. Multiple large-scale trials from around the world have produced conflicting outcomes in cancer-specific and overall mortality. A main part of the issue is the PSA test, which has a high degree of variability, making it challenging to set PSA thresholds, as well as limited specificity.

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Context: Each year the European Association of Urology (EAU) produce a document based on the most recent evidence on the diagnosis, therapy, and follow-up of testicular cancer (TC).

Objective: To represent a summarised version of the EAU guidelines on TC for 2023 with a focus on key changes in the 2023 update.

Evidence Acquisition: A multidisciplinary panel of TC experts, comprising urologists, medical and radiation oncologists, and pathologists, reviewed the results from a structured literature search to compile the guidelines document.

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Objectives: To investigate which infertile men with semen parameters above WHO reference limits at first semen analysis deserve a second semen test.

Materials And Methods: Data from 1358 consecutive infertile men were analysed. Patients underwent two consecutive semen analyses at the same laboratory.

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Objective: To (i) identify a novel risk stratification for patients complaining of haemospermia; and, (ii) compare its predictive ability to select high-risk patients by retrospectively validating the EAU guidelines classification.

Methods: Data from 283 consecutive patients complaining of a single episode/recurrent haemospermia were retrospectively analyzed. Patients were stratified into low vs high-risk according to EAU guidelines, whose diagnostic performance was then validated.

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Background: Erectile dysfunction aetiology has been historically identified as organic, psychogenic and mixed.

Objectives: To stratify and compare a cohort of patients seeking medical help for erectile dysfunction for the first time according to the newly proposed binary classification of the European Association of Urology guidelines: 'primary organic' versus 'primary psychogenic'.

Materials And Methods: Complete data from 2009 consecutive patients presenting for erectile dysfunction were analysed.

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Purpose: To describe the perioperative safety, functional and immediate post-operative oncological outcomes of minimally invasive RPLND (miRPLND) for testis cancer.

Methods: We performed a retrospective multi-centre cohort study on testis cancer patients treated with miRPLND from 16 institutions in eight countries. We measured clinician-reported outcomes stratified by indication.

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Study Question: we aimed to investigate the relationship between the tyg index and both semen and hormonal characteristics in a cohort of primary infertile men. Summary answer: almost one in two primary infertile men presented with a triglycerides/glucose index (tyg) suggestive of insulin resistance (ir). overall, patients with tyg suggestive of ir showed worse clinical, hormonal, and semen parameters.

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Background/aims: The new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a wide spectrum of effects, including acute kidney injury (AKI) in up to 40% of hospitalized patients. Given the established relationship between AKI and poor prognosis, whether AKI might be a prognostic indicator for patients admitted to the hospital for SARS-CoV-2 infection would allow for a straightforward risk stratification of these patients.

Methods: We analyzed data of 623 patients admitted to San Raffaele Hospital (Milan, IT) between February 25 and April 19, 2020, for laboratory-confirmed SARS-CoV-2 infection.

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Article Synopsis
  • The study aimed to create a model that predicts azoospermia, which is the absence of sperm in semen, without needing a semen analysis for men experiencing infertility.
  • Two predictive algorithms were developed: one using only follicle stimulating hormone (FSH) and another that also included age, luteinizing hormone, total testosterone, and testis volume.
  • The algorithms were validated with data from three cities (Miami, Milan, and Chicago), showing good predictive performance, which could help in cases where a semen analysis is difficult to obtain.
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Aim: Since its discovery Prostate Specific Antigen (PSA), also referred to as kallikrein-3 (KLK3), has been used as standard circulating biomarker for prostate cancer (PCa). However, its specificity remains not adequate and its mechanism of action still elusive. Therefore, deciphering PSA role throughout PCa-pathobiology would be relevant in improving both cancer diagnosis and outcome prediction.

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Background: A severe male infertility factor has been associated with both lower health status and increased mortality in infertile men.

Objectives: To investigate reproductive factors associated with health status impairment in infertile men over a 10-year time frame since the first clinical evaluation.

Materials And Methods: Data from 899 infertile men were analysed at baseline between 2003 and 2010.

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Background: The EAU guidelines on male sexual and reproductive health state that both partners of the infertile couple should undergo simultaneous investigation.

Objectives: To assess the prevalence and the characteristics of infertile men who were referred for an andrological evaluation after failed attempts of Assisted Reproductive Technology (ART) with those who were evaluated at the beginning of their infertility pathway at a single academic centre over a 17-year period.

Materials And Methods: Data of 3213 primary infertile couples assessed between 2003 and 2020 were analysed.

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Background And Objective: Few studies have investigated the association between surgical volume and outcome of robot-assisted radical prostatectomy (RARP) in an unselected cohort. We sought to investigate the association between surgical volume with peri-operative and short-term outcomes in a nation-wide, population-based study group.

Methods: 9,810 RARP's registered in the National Prostate Cancer Register of Sweden (2015-2018) were included.

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Aim: To assess the prevalence of isolated teratozoospermia (iTZS) in a cohort of infertile and fertile men; explore the relationship between iTZS, inflammatory parameters and sperm DNA fragmentation index (SDF) in the same cohort.

Materials And Methods: 1824 infertile men and 103 fertile controls. Semen analysis, the neutrophil-to-lymphocyte ratio (NLR) and serum hormones were investigated.

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Background: Holmium laser enucleation of the prostate (HoLEP) is considered a challenging procedure with a non-negligible risk of complications limiting its widespread adoption. We investigated rates and preoperative predictors of complications in a high-volume center with long-time experience.

Methods: Data from 284 patients treated with HoLEP between 2015 and 2017 were analyzed.

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