Publications by authors named "Giovanni Lughezzani"
Background: Factors associated with cancer survivors' preventive health behaviors are understudied. We hypothesized that socioeconomic and healthcare access factors may be associated with adherence to recommended cancer screenings.
Methods: We conducted a cross-sectional analysis using the 2020 Behavioral Risk Factor Surveillance System.
The Evaluation of Radiolabeled Prostate-Specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Initial Staging in Intermediate-Risk Prostate Cancer Patients: A Retrospective Multicenter Analysis.
Laura Evangelista Priscilla Guglielmo Giulia Giacoppo Lucia Setti Demetrio Aricò Giovanni Lughezzani
Diagnostics (Basel)
December 2024
Objectives: The aim of the present study was to assess the performance of radiolabeled-PSMA PET/CT in a cohort of intermediate-risk prostate cancer (PCa) patients for initial staging.
Methods: This is a retrospective, multicenter analysis of patients diagnosed with intermediate-risk PCa who were staged using radiolabeled PSMA PET/CT to evaluate the extent of the disease before initiating appropriate treatment. The study included patients from the Nuclear Medicine Units of the Humanitas group between 2021 and 2024.
Article Synopsis
- The study examines the impact of smoking on the outcomes of nonmuscle invasive bladder cancer (NMIBC) treated with BCG instillations, indicating that smokers may have poorer results.
- Approximately 1,313 patients were analyzed using a statistical model to correlate smoking history with disease progression, revealing that heavy smokers have over double the risk of disease progression compared to nonsmokers.
- The results highlight the importance of considering a patient's smoking history in NMIBC management and the necessity for tailored smoking cessation strategies in treatment plans.
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
- 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.
Article Synopsis
- Intravesical recurrence of upper tract urothelial carcinoma after radical nephroureterectomy occurs in 22% to 47%, prompting the need for effective intravesical chemotherapy, which remains underused due to safety and efficacy concerns.
- A systematic review analyzed 18 studies with 2,483 patients, finding that intravesical chemotherapy significantly lowered the risk of recurrence at 12 months (OR=0.46) and 24 months (OR=0.41) after surgery.
- The study highlighted a favorable safety profile for intravesical chemotherapy, showing only 9% minor and 0.9% major complications, while the optimal instillation methods require further investigation.
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.
Multiparametric magnetic resonance imaging (mpMRI) has made dramatic inroads into the management of localized prostate cancer (PCa); however, not all suspicious lesions represent clinically significant (cs) PCa. We aimed to analyze the hypothetical effect of incorporating tumor volume ratio (TVR) into prostate biopsy (PBx) decision-making. Two hundred and fifty-two patients with suspicious lesions at mpMRI undergoing transperineal PBx under local anesthesia between 2019 and 2022 were retrospectively evaluated.
View Article and Find Full Text PDFArticle 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
- - 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
- 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 aimed to analyze the use of same-day discharge (SDD) after robot-assisted laparoscopic prostatectomy (RALP) and its effects on patient outcomes during the "Pre-pandemic" (2018-2019) and "Pandemic" (2020) periods.
- Data from the National Cancer Database was used to compare patient and hospital characteristics, as well as the likelihood of SDD and its impact on mortality and readmissions.
- Results showed that SDD rates increased during the pandemic, with no significant differences in 30-day or 90-day mortality or readmissions between SDD and non-SDD patients, highlighting the importance of resources for standardizing SDD in the future.
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
- E-cigarette use has risen notably among older individuals, raising questions about its impact on preventive health behaviors like prostate specific antigen (PSA) screening among smokers.
- A study analyzed data from men aged 50-69 to investigate the correlation between e-cigarette use and PSA screening rates, finding that 28.3% had received screening.
- Results indicated that e-cigarette smokers were significantly less likely to undergo PSA screening compared to both never-smokers and tobacco smokers, potentially due to fewer primary care visits.
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
A Propensity Score-matched Comparison of Micro-ultrasound-guided Transrectal and Magnetic Resonance Imaging/Transrectal Ultrasound Fusion-guided Transperineal Prostate Biopsies for Detection of Clinically Significant Prostate Cancer.
Andrea Piccolini Pier Paolo Avolio Cesare Saitta Edoardo Beatrici Stefano Moretto Giovanni Lughezzani
Eur Urol Open Sci
November 2024
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.
The Impact of Radical Prostatectomy Versus Radiation Therapy on Cancer-Specific Mortality for Nonmetastatic Prostate Cancer: Analysis of an Other-Cause Mortality Matched Cohort.
Marco Finati Nicholas James Corsi Alex Stephens Giuseppe Chiarelli Giuseppe Ottone Cirulli Giovanni Lughezzani
Clin Genitourin Cancer
December 2024
Article 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 PDFImpact of Prostate-Specific Antigen Screening Pattern on Prostate Cancer Mortality Among Non-Hispanic Black and Non-Hispanic White Men: A Large, Urban Health System Cohort Analysis.
Giuseppe Ottone Cirulli Matthew Davis Alex Stephens Giuseppe Chiarelli Marco Finati Giovanni Lughezzani
J Urol
October 2024
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.*
Background And Objective: Micro-ultrasound (MUS) uses a high-frequency transducer with superior resolution to conventional ultrasound, which may differentiate prostate cancer from normal tissue and thereby allow targeted biopsy. Preliminary evidence has shown comparable sensitivity to magnetic resonance imaging (MRI), but consistency between users has yet to be described. Our objective was to assess agreement of MUS interpretation across multiple readers.
View Article and Find Full Text PDFClinically significant prostate cancer detection rate in biopsy-naïve patients with mpMRI and microultrasound topographically discordant lesions: A single-center retrospective analysis.
Filippo Dagnino Pier Paolo Avolio Vittorio Fasulo Andrea Piccolini Muhannad Aljoulani Giovanni Lughezzani
Urol Oncol
December 2024
Article Synopsis
- Multiparametric magnetic resonance imaging (mpMRI) and microultrasound (micro-US) are both effective technologies for detecting significant prostate cancer, but they differ in their performance in biopsy-naïve patients with discordant lesions.
- In a study of 178 men, micro-US-guided targeted biopsy (micro-US-TBx) showed a higher detection rate for clinically significant prostate cancer (csPCa) compared to mpMRI-guided targeted biopsy (MTBx), with 20% vs. 16% respectively.
- The combination of mpMRI and micro-US improved detection rates for both clinically significant and clinically insignificant prostate cancer, indicating their synergistic value when used together.
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
- The study compared the effectiveness of magnetic resonance imaging-guided targeted biopsy (MTBx) alone versus combining it with systematic biopsy (SBx) for detecting prostate cancer (PCa) and clinically significant PCa (csPCa) in men undergoing outpatient transperineal biopsies under local anesthesia.* -
- Out of 255 men reviewed, the detection rates for PCa were similar between MTBx (56%) and the MTBx plus SBx combination (61%), with both methods showing comparable results for csPCa, despite MTBx requiring fewer biopsy cores (6 vs. 11).* -
- Factors predicting csPCa included age, prior negative biopsies, prostate-specific antigen density, and specific imaging scores