Publications by authors named "Giorgio Guazzoni"

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.
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  • The study checks how well different types of biopsies (tests to check for prostate cancer) work in men with specific MRI findings called PI-RADS 5.
  • It compares a combined method of targeted biopsy (CTBx) with another method that includes a regular biopsy (SBx) to see which one finds more cases of prostate cancer.
  • The results suggest that the combined method is just as good at finding cancer, and it can avoid a lot of unnecessary regular biopsies, making it a better option for patients.
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Liquid biopsy (LB) for prostate cancer (PCa) detection could represent an alternative to biopsy. Seminal fluid (SF) is a source of PCa-specific biomarkers, as 40% of ejaculate derives from the prostate. We tested the feasibility of an SF-based LB by evaluating the yield of semen self-sampling in a cohort of >750 patients with clinically localized PCa.

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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.
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Background: This prospective single-arm study is designed to compare in parallel 68Ga-PSMA PET/TRUS (transrectal or transperineal) fusion biopsy ("experimental test") with multiparametric MRI (mpMRI)/TRUS fusion prostate biopsy ("standard test") in men with a high suspicion of prostate cancer (PCa) after at least one negative biopsy. The primary objective was to evaluate the diagnostic performance of 68Ga-PSMA PET/TRUS fusion prostate biopsy in comparison to mpMRI/TRUS fusion prostate biopsy analyzed in parallel. Secondarily, we aimed to determine the relationship between the "experimental test" and the histopathological characteristics of the specimen, along with the clinical utility of the "experimental test" compared to the "standard test.

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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.

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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.
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Article Synopsis
  • Recent research explored using immunohistochemical protein markers to classify bladder cancer, but no established tissue biomarkers can accurately predict patient survival or chemotherapy response in urothelial carcinoma (UC).
  • In a study involving 251 patients with muscle-invasive bladder carcinoma, immunohistochemical analysis divided tumors into basal, luminal, mixed, and neu-like subtypes based on expression of specific markers.
  • Findings showed a significant percentage of tumors exhibited phenotypical changes between non-muscle-invasive and muscle-invasive stages, with basal tumors remaining more stable compared to others, and a better overall survival in luminal tumors transitioning to basal types.
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Objectives: The aim of this study is to assess whether restaging transurethral resection (ReTUR) could be safely replaced with urine cytology (UC) and in-office fiexible cystoscopy in selected T1 non-muscle-invasive bladder cancer (NMIBC).

Materials And Methods: This is an ongoing prospective multicenter trial enrolling patients diagnosed with T1 BC from 5 Italian centers. Patients with a macroscopically incomplete initial resection or absence of detrusor muscle were subjected to ReTUR according to European Association of Urology (EAU) guidelines.

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Background: MRI has been proposed as a new staging tool for bladder cancer (BC), but use is limited by its high costs and low availability. 29-MHz high-resolution micro-ultrasound (mUS) technology has been suggested as an alternative to detect BC and distinguish between muscle-invasive and non-muscle invasive BC.

Objective: The aim was to compare the diagnostic accuracy of mUS vs.

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Introduction: To externally validate and directly compare the performance of the Briganti 2012 and Briganti 2019 nomograms as predictors of lymph node invasion (LNI) in a cohort of patients treated with robot-assisted radical prostatectomy (RARP) and extended pelvic lymph node dissection (ePLND).

Materials And Methods: After the exclusion of patients with incomplete biopsy, imaging, or clinical data, 752 patients who underwent RARP and ePLND between December 2014 to August 2021 at our center, were included. Among these patients, 327 (43.

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Objectives: To test the hypothesis that patients under active surveillance (AS) for Non-muscle Invasive Bladder Cancer (NMIBC) who were negative on longitudinal re-testing by the Xpert Bladder Cancer Monitor (Xpert BC Monitor) assay may avoid unnecessary cystoscopies and urine cytology (UC).

Subjects/patients Or Materials And Methods: This is a prospective cohort study of patients enrolled in the AS protocol for recurrent NMIBC (Bladder Cancer Italian Active Surveillance, BIAS project), whose urine samples were analyzed by Xpert BC Monitor upon entry in the study (T0). Patients who had a negative Xpert test and did not fail AS, underwent additional Xpert tests after 4 (T1), 8 (T2), and 12 (T3) months.

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Purpose: We aim to evaluate the accuracy of micro-ultrasound (microUS) in predicting extraprostatic extension (EPE) of Prostate Cancer (PCa) prior to surgery.

Methods: Patients with biopsy-proven PCa scheduled for robot-assisted radical prostatectomy (RARP) were prospectively recruited. The following MRI-derived microUS features were evaluated: capsular bulging, visible breach of the prostate capsule (visible extracapsular extension; ECE), presence of hypoechoic halo, and obliteration of the vesicle-prostatic angle.

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Objective: Many individuals with bladder cancer have undergone a surgical urostomy and often complain of being self-conscious of the unpleasant smell of their own urine. The focus of this study was to test the efficacy of a pouch cover made of a carbon and zeolite containing polyester material to inhibit the smell of urine by comparing two trained dogs' response time in detecting volatile organic compounds (VOCs) in urine, with and without the fabric covering the samples.

Methods: This study used a randomized, blinded experimental design to evaluate the efficacy of a fabric to interfere with two highly trained dogs' ability to detect specific VOCs present in the urine of prostate cancer patient.

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Hippocrates (Kos, c.460–c.370 BC) reminds us that “It is more important to know what sort of person has a disease than to know what sort of disease a person has”.

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Background: Bladder cancer (BC) staging is challenging. There is an important need for available and affordable predictors to assess, in combination with imaging, the presence of locally-advanced disease.

Objective: To determine the role of the De Ritis ratio (DRR) and neutrophils to lymphocytes ratio (NLR) in the prediction of locally-advanced disease defined as the presence of extravescical extension (pT ⩾ 3) and/or lymph node metastases (LNM) in patients with BC treated with radical cystectomy (RC).

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Background: En bloc resection (ERBT) is a valid alternative to piecemeal resection for non-muscle-invasive bladder cancer (NMIBC), guaranteeing pathological outcomes. However, very few studies investigated long-term oncological outcomes of ERBT.

Objective: To report long-term oncological outcome of ERBT.

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Introduction: Magnetic Resonance Imaging (MRI) has emerged as the most accurate diagnostic tool, showing a high sensitivity in the diagnosis of clinically significant prostate cancer (csCaP). However only a minority of patients with a PI-RADS 3 lesion at multiparametric magnetic resonance imaging (MRI) are diagnosed with csCaP. The aim of the current study was to assess whether high resolution micro-ultrasound (microUS) could help in sub-stratifying the risk of csCaP in this specific population.

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Circulating cell-free DNA (ccfDNA), released from normal and cancerous cells, is a promising biomarker for cancer detection as in neoplastic patients it is enriched in tumor-derived DNA (ctDNA). ctDNA contains cancer-specific mutations and epigenetic modifications, which can have diagnostic/prognostic value. However, in primary tumors, and in particular in localized prostate cancer (PCa), the fraction of ctDNA is very low and conventional strategies to study ccfDNA are unsuccessful.

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Active surveillance (AS) has been proposed as an alternative to transurethral resection (TUR) in selected patients with recurrent low-risk non-muscle-invasive bladder cancer (NMIBC). Here we report long-term results for patients on AS and investigate features associated with AS failure. Cases with recurrence after diagnosis of low-grade (LG) pTa/pT1a NMIBC were enrolled in the Bladder Italian Active Surveillance (BIAS) project.

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Optimal retroperitoneal space creation is of pivotal importance in laparoscopic retroperitoneal surgery. The aim of this study is to report the balloon dissecting technique developed at our institution, comparing the costs of such device with that of the commercially available balloon retroperitoneal expanders. Twenty patients, scheduled to undergo retroperitoneoscopic surgery, were randomly divided into two groups.

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Purpose: To evaluate the feasibility, safety, and efficacy of ultrasound-guided transperineal laser ablation (TPLA) as a new minimally invasive surgical therapy (MIST) for the treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).

Materials And Methods: Under local anesthesia and conscious sedation up to two laser fibers for each prostatic lobe were inserted under US-guidance by a percutaneous approach. TPLA was performed using a continuous wave diode laser (SoracteLite-EchoLaserX4) able to generate a light-induced thermal heating and subsequent coagulative necrosis of the prostatic tissue.

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