Publications by authors named "Cesare Saitta"
Article Synopsis
- - The study aimed to create a preoperative tool called NODESAFE to predict nodal involvement (NI) in patients with localized renal cell carcinoma (RCC) before surgery, addressing the ongoing debate about the need for lymphadenectomy.
- - Researchers conducted a multicenter analysis of 3,308 RCC patients who had primary surgical resections, excluding those with clinical metastasis, using a stepwise logistic regression model to identify significant predictive factors for NI, achieving an AUC of 0.89 in validation.
- - The final NODESAFE model included factors like hypertension, tumor size, and CRP levels, demonstrating high sensitivity (83.9%) and specificity (86.1%), which could enhance clinical decision-making
Article Synopsis
- This study examines how the Mayo Adhesive Probability (MAP) score and body mass index (BMI) affect kidney function decline after patients undergo robotic assisted partial nephrectomy (RAPN).
- A total of 258 patients were analyzed over a median follow-up of 33 months, revealing that a higher MAP score and increased BMI are correlated with a greater risk of developing chronic kidney disease stage 3 (CKD-S3).
- The findings suggest that higher MAP scores and obesity can negatively impact long-term kidney function, indicating a need for careful monitoring before surgery in at-risk patients.
Article Synopsis
- The study aimed to compare the effectiveness of high-resolution micro-ultrasound-guided transrectal biopsy (TRBx) versus MRI/conventional transrectal ultrasound-guided transperineal biopsy (TPBx) in detecting clinically significant prostate cancer (csPCa).
- Researchers analyzed data from 1,423 men who underwent prostate biopsies and found no significant difference in csPCa detection rates between the two methods (45% for TRBx and 51% for TPBx).
- The study identified key predictors for csPCa detection, including family history, age, positive digital rectal exam results, prostate-specific antigen density, and specific imaging scores, while noting limitations like the retrospective nature of the data analysis.
Article Synopsis
- This study compares outcomes of radical nephrectomy (RN) versus partial nephrectomy (PN) for treating sarcomatoid renal cell carcinoma (sRCC) using a large national database from 2004 to 2019.
- The analysis found that patients receiving PN had better overall survival rates, particularly in early-stage tumors (cT1 and cT3), although factors like age and tumor characteristics influenced the likelihood of receiving PN.
- The results suggest that PN can be a viable option for certain patients without compromising outcomes, but disparities in care exist based on income and insurance status, affecting survival rates.
Objective: To evaluate predictive ability of a novel combined index, Charlson comorbidity index and C-reactive protein (CCI-CRP), for outcomes in renal cell carcinoma (RCC), and compare predictive outcomes with of CCI-CRP to its separate components and to the UCLA integrated staging system (UISS).
Patients And Methods: We retrospectively analyzed INMARC registry of RCC patients. Receiver Operator Characteristics (ROC) analysis was fitted to identify threshold defining low-CRP (LCRP) and high-CRP (HCRP).
Objective: Stage migration in renal cell carcinoma (RCC) has led to an increasing proportion of diagnosed small renal masses. Emerging knowledge regarding heterogeneity of RCC histologies and consequent impact on prognosis led us to further explore outcomes and predictive factors in surgically-treated T1a RCC.
Methods: The INMARC database was queried for T1aN0M0 RCC.
Background: To evaluate relationship between histological subtypes of renal cell carcinoma (RCC) and preoperative c-reactive protein (CRP).
Patients And Methods: We queried the International Marker Consortium for Renal Cancer database for patients affected by RCC. Patients were classified according to their histology: benign tumors, clear cell (cc) RCC, chromophobe (ch) RCC, papillary (p) RCC, and variant histology (vh) RCC; and according to CRP (mg/L): low CRP ≤5 and high CRP >5.
: to investigate the impact of age on renal function deterioration after robotic-assisted partial nephrectomy (RAPN) focusing on a decline to moderate and severe forms of chronic kidney disease (CKD). : This is a single center prospective analysis of patients who underwent RAPN. The outcomes include the development of de novo CKD-S 3a [estimated glomerular filtration rate (eGFR) < 60 mL/min/1.
View Article and Find Full Text PDFBackground: The diagnostic process for prostate cancer after a negative biopsy is challenging. This study compares the diagnostic accuracy of micro-ultrasound (mUS) with multiparametric magnetic resonance imaging (mpMRI) for such cases.
Methods: A retrospective cohort study was performed, targeting men with previous negative biopsies and using mUS and mpMRI to detect prostate cancer and clinically significant prostate cancer (csPCa).
Objective: To investigate impact of body mass index (BMI) on survival across different histologies and stages of renal cell carcinoma (RCC).
Methods: We conducted a retrospective multicenter analysis of clear cell (ccRCC) and non-ccRCC. Obesity was defined according to the WHO criteria (non-Asian BMI >30 Kg/m, Asian BMI >27.
Article Synopsis
- Scientists wanted to see how well two types of prostate cancer tests worked for men who had suspicious signs during exams and scans.
- They found that using microultrasound-targeted biopsy (microUSTBx) with systematic biopsy (SBx) found cancer just as well as another method called mpMRI with targeted biopsy (MTBx).
- This new method not only helped find cancer accurately but also prevented many unnecessary tests, making it a better choice for some patients.
Objective: To create and validate 2 models called RENSAFE (RENalSAFEty) to predict postoperative acute kidney injury (AKI) and development of chronic kidney disease (CKD) stage 3b in patients undergoing partial (PN) or radical nephrectomy (RN) for kidney cancer.
Methods: Primary objective was to develop a predictive model for AKI (reduction >25% of preoperative eGFR) and de novo CKD≥3b (<45 ml/min/1.73m), through stepwise logistic regression.
Article Synopsis
- - Liquid biopsy using seminal fluid as a source for prostate cancer biomarkers was tested on over 750 patients but achieved a low sample yield of 18.2%, primarily due to limited patient consent. * ! - Younger patients and those with smaller prostate volumes were more likely to provide samples, and a method was developed to isolate prostate-derived cells from both seminal fluid and urine. * ! - Analysis revealed that while prostate-enriched cells were more prevalent in seminal fluid, the presence of cancerous cells was not sufficient to make a diagnosis, indicating that more detailed molecular testing is necessary for accurate prostate cancer detection.
Background: T1 high-grade (HG) non-muscle invasive bladder cancer (NMIBC) has a significant risk of recurrence and progression, and the European Association of Urology recommends a second transurethral resection of the bladder (ReTUR). Stage at ReTUR has been shown to be a reliable predictor of survival, therefore, we sought to assess clinical and pathological predictors associated with the persistence of T1 at ReTUR in our retrospective multicentric cohort.
Methods: This is a retrospective multicentric study of T1 HG patients at transurethral resection of the bladder (TURB) who underwent subsequent ReTUR.
Purpose: We hypothesized that two-tier re-classification of the "M" (metastasis) domain of the Tumor-Node-Metastasis (TNM) staging of Renal Cell Carcinoma (RCC) may improve staging accuracy than the current monolithic classification, as advancements in the understanding of tumor biology have led to increased recognition of the heterogeneous potential of metastatic RCC (mRCC).
Methods: Multicenter retrospective analysis of patients from the REMARCC (REgistry of MetAstatic RCC) database. Patients were stratified by number of metastases into two groups, M1 (≤3, "Oligometastatic") and M2 (>3, "Polymetastatic").
Article Synopsis
- Active surveillance (AS) is a common approach for managing low-risk prostate cancer, but identifying candidates for AS is difficult; this study investigates the effectiveness of microultrasound (microUS) in conjunction with mpMRI for monitoring these patients.
- A total of 100 prostate cancer patients underwent TRUS with microUS and targeted biopsies, revealing that 34 patients were upgraded to more significant disease at confirmatory biopsies, highlighting microUS's role in identifying clinically relevant cancer.
- The findings indicate that both microUS and mpMRI are highly sensitive tools for detecting clinically significant prostate cancer, which could improve decision-making in the management of patients undergoing active surveillance.
Patients with pT1 high-grade (HG) urothelial carcinoma (UC) and a very high risk of progression might benefit from immediate radical cystectomy (RC), but this option remains controversial. Validation of a standardized method to evaluate the extent of lamina propria (LP) invasion (with recognized prognostic value) in transurethral resection (TURBT) specimens is still needed. The Rete Oncologica Lombarda (ROL) system showed a high predictive value for progression after TURBT in recent retrospective studies.
View Article and Find Full Text PDFAssessing the Role of High-resolution Microultrasound Among Naïve Patients with Negative Multiparametric Magnetic Resonance Imaging and a Persistently High Suspicion of Prostate Cancer.
Eur Urol Open Sci
January 2023
Background: Multiparametric magnetic resonance imaging (mpMRI) is an invaluable diagnostic tool in the decision-making for prostate biopsies (PBx). However, a non-negligible proportion of patients with negative MRI (nMRI) may still harbour prostate cancer (PCa).
Objective: To assess whether microultrasound (micro-US) can help in substratifying the presence of PCa and clinically significant PCa (csPCa; ie, any Gleason score ≥7 PCa) in patients with nMRI despite a persistently high clinical suspicion of PCa.
Article Synopsis
- The study looked at how a specific genetic change (T2:ERG) could be linked to imaging scores used to check for prostate cancer (PCa).
- It involved 158 men who were suspected of having PCa and who underwent biopsies to confirm the diagnosis.
- The results showed that a majority of the patients had PCa, and combining the genetic test with imaging scores improved the ability to accurately diagnose clinically significant prostate cancer.
Article Synopsis
- - The study aimed to identify factors that predict the risk of cancer after Testis Sparing Surgery (TSS) in patients with small testicular lesions found during fertility evaluations.
- - Researchers analyzed data from 64 patients who underwent TSS from 2002 to 2020, finding that characteristics like lesion size, hypervascularization, and multifocality were significant predictors of malignancy, with smaller lesions (under 5 mm) typically being benign.
- - The findings suggest that ultrasound characteristics and the appearance of testicular lesions during surgery can help determine the malignant potential, supporting the safe use of TSS in selected patients.
Background: Many of the effects of pneumoperitoneum on cardiovascular, respiratory and metabolic systems have been discussed in Literature, but very little is known about the variations of the hemocoagulative parameters in patients undergoing laparoscopic surgery. The purpose of this study is to analyze the variations of the hemocoagulative parameters in patients undergoing elective laparoscopic cholecystectomy for symptomatic gallbladder stones. An eventual statistically significant difference linked to different pressure settings of pneumoperitoneum will allow selecting a specific intrabdominal pressure for a more adequate treatment with a lower incidence of pneumoperitoneum related complications.
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