Publications by authors named "Gontero Paolo"

This study aims to report the oncological, surgical and functional outcomes in 15 patients with locally advanced penile cancer who underwent total penile amputation with perineal urethrostomy (PU). A single-center retrospective analysis was conducted from January 2018 to September 2023. Outcomes included postoperative complications, cancer-specific survival (CSS), and overall survival (OS).

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF

Background: Multiparametric magnetic resonance imaging (mpMRI) is pivotal in prostate cancer (PCa) diagnosis, but some clinically significant (cs) PCa remain undetected. This study aims to understand the pathological and molecular basis for csPCa visibility at mpMRI.

Methods: We performed a retrospective matched-pair cohort study, including patients undergoing radical prostatectomy (RP) for csPCa (i.

View Article and Find Full Text PDF

Introduction: Prostate cancer incidence in immunosuppressed transplant recipients increases as life expectancy improves in this population. However, the management of treatments and immunosuppressive (IS) regimens for solid organ transplant recipients diagnosed with prostate cancer remains poorly defined. Therefore, we conducted a multicentric study to investigate these parameters more thoroughly.

View Article and Find Full Text PDF
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.
View Article and Find Full Text PDF
Article Synopsis
  • Targeted microwave ablation (TMA) shows promise as a safe and effective treatment for localized prostate cancer, based on a pilot trial involving 11 patients.* -
  • No severe complications were reported, and a significant percentage of patients exhibited no cancer in the treated area after follow-up, although new cancer foci were found in some cases.* -
  • The study acknowledges limitations such as a small sample size, short follow-up duration, and absence of a comparison group, but supports the potential of TMA combined with fusion imaging for prostate cancer therapy.*
View Article and Find Full Text PDF

Background And Objective: Non-muscle-invasive bladder cancer (NMIBC) poses a significant clinical challenge, particularly when failing bacillus Calmette-Guérin (BCG) therapy, necessitating alternative treatments. Despite radical cystectomy being the recommended treatment, many patients are unfit or unwilling to undergo this invasive procedure, highlighting the need for effective bladder-sparing therapies. This review aims to summarize and report the evidence on the efficacy and to estimate the costs of bladder-preserving strategies used in NMIBC recurrence after failure of intravesical BCG therapy.

View Article and Find Full Text PDF

Objective: Sparse data exist on the impact of upper urinary tract (UUT) decompression on the risk of UUT recurrence in patients with bladder cancer (BCa). This study aims to evaluate whether Double J stenting (DJS) can increase the risk of UUT recurrence compared to percutaneous nephrostomy (PCN) placement.

Materials And Methods: We retrospectively analyzed data from 1550 patients with cTa-T3NanyM0 BCa who underwent radical cystectomy (RC) between at 12 tertiary care centers (1990-2020).

View Article and Find Full Text PDF

Purpose: There is lack of evidence regarding the indication for re-transurethral resection of bladder tumor (reTURBT) for Ta high grade (HG) non-muscle invasive bladder cancer (NMIBC). This study aims to evaluate the oncological outcomes of patients with TaHG NMIBC to determine the benefit from performing reTURBT.

Methods: We relied on a multicenter cohort of 317 TaHG NMIBC from 12 centers who underwent TURBT and a subsequent complete Bacillus Calmette-Guérin induction from 2009 to 2021.

View Article and Find Full Text PDF

Adult Acquired Buried Penis (AABP) is a morbid condition that often requires surgical intervention. This retrospective study of 46 patients who underwent AABP surgery from November 2017 to July 2023 evaluates surgical outcomes, functional outcomes, and patient-reported outcomes. The median follow-up (FU) was 46 months.

View Article and Find Full Text PDF

Although high-level evidence is currently lacking, noninferiority randomised controlled trials in predefined risk groups in non-muscle-invasive bladder cancer are under way to scientifically prove the safety of urinary biomarker-guided follow-up. To facilitate recommendations for clinical use, it is essential to comply with the EU certification for in vitro diagnostics and to demonstrate cost effectiveness.

View Article and Find Full Text PDF

Objective: To investigate the impact of ageing on survival outcomes in Bacillus Calmette-Guérin (BCG) treated non-muscle invasive bladder cancer (NMIBC) patients and its synergy with adequate BCG treatment.

Method: Patients with NMIBC who received BCG treatment from 2001 to 2020 were divided into group 1 (< = 70 years) and group 2 (> 70 years). Overall Survival (OS), Cancer-Specific Survival (CSS), Recurrence-Free Survival (RFS), and Progression-Free Survival (PFS) were analyzed using the Kaplan-Meier method.

View Article and Find Full Text PDF

Purpose: To evaluate biopsy-related complications and detection rates of any PCa and clinically significant PCa (csPCa, intended as grade group ≥ 2) between MRI-targeted TP fusion biopsies (TPBx) and TR ones (TRBx).

Methods: We performed a multicentric study on 4841 patients who underwent fusion biopsy between 2016 and 2023. A case-control matching was performed to find comparable cohorts of 646 TPBx and 646 TRBx.

View Article and Find Full Text PDF

This prospective study aimed to (1) compare the diagnostic performance of Ga-PSMA-11 PET/CT with respect to conventional imaging (computed tomography (CT) and bone scintigraphy (BS)) in the primary staging of high-risk prostate cancer (PCa) patients and (2) validate PSMA-PET/CT accuracy in pelvic nodal staging in comparison with postoperative histopathology and assess PSMA-PET/CT's impact on patient management. Sixty castration-sensitive high-risk (ISUP 4-5 and/or PSA > 20 ng/mL and/or cT3) PCa patients eligible for radical prostatectomy were enrolled (median PSA 10.10 [IQR: 6.

View Article and Find Full Text PDF

The European Association of Urology (EAU), National Comprehensive Cancer Network, and European Society for Medical Oncology guidelines recommend PD-L1 and FGFR testing for patients with locally advanced bladder cancer or upper tract urothelial cancer (UTUC) according to specific eligibility criteria; positive results indicate therapy with immune checkpoint inhibitors or erdafitinib, respectively. The EAU guidelines recommend PD-L1 testing for subsequent adjuvant therapy in high-risk UC, and germline DNA sequencing in patients with UTUC positive for DNA mismatch repair alterations.

View Article and Find Full Text PDF

Background And Objective: More than 10% of patients with negative clinical metastatic status (cN0M0) on conventional imaging for prostate cancer (PCa) harbor lymph node involvement (pN+) at final pathology following radical prostatectomy (RP) and lymphadenectomy. Our aim was to assess outcomes of initial observation for cN0M0 pN+ PCa and identify prognostic factors that may help in clinical decision-making.

Methods: We performed a retrospective multicenter study of patients with cN0M0 PCa on conventional imaging (computed tomography and/or magnetic resonance imaging, and a bone scan) who were found to have pN+ disease at RP between 2000 and 2021.

View Article and Find Full Text PDF

Background: Since its initial description the prostate biopsy technique for detection of prostate cancer (PCA) has constantly evolved. Multiparametric magnetic resonance imaging (mpMRI) has been proven to have a sensitivity exceeding 90% to detect the index lesion. This narrative review discusses the evidence around several biopsy strategies, especially in the context of patients that might be eligible for focal therapy.

View Article and Find Full Text PDF

Introduction: To date, radio-recurrent prostate cancer (PCa) ranks as the fourth most common urological malignancy when considering the number of men with localized PCa who undergo radiation treatment and subsequently experience a biochemical recurrence. This systematic review aimed to summarize available evidence about the outcomes of local salvage strategies in patients with local PCa recurrence following primary external-beam radiation therapy (EBRT).

Methods: We conducted a comprehensive bibliographic search on MEDLINE, Scopus, and Web of Science Core Collection databases in October 2023 to identify studies published in the last 20 years evaluating outcomes of local salvage procedures in patients with locally radio-recurrent PCa following EBRT.

View Article and Find Full Text PDF

Background And Objective: Management of low-grade (LG) urothelium-confined (Ta stage) non-muscle-invasive bladder cancer (NMIBC) poses a distinct therapeutic challenge. Transurethral resection of bladder tumor (TURBT), the standard treatment, frequently has to be repeated because of high tumor recurrence rates. This places a considerable strain on both patients and health care infrastructure, underscoring the need for alternative management approaches.

View Article and Find Full Text PDF

Grade is an important determinant of progression in non-muscle-invasive bladder cancer. Although the World Health Organization (WHO) 2004/2016 grading system is recommended, other systems such as WHO1973 and WHO1999 are still widely used. Recently, a hybrid (three-tier) system was proposed, separating WHO2004/2016 high grade (HG) into HG/grade 2 (G2) and HG/G3 while maintaining low grade.

View Article and Find Full Text PDF

The first-line treatment of penile cancer confined to the glans (Tis-T2) is based on organ-sparing approaches. Our aim is to report functional outcomes of total glans resurfacing (TGR), wide local excision (WLE) and glansectomy. A retrospective analysis was conducted from January 2013 to October 2022.

View Article and Find Full Text PDF
Article Synopsis
  • Radical nephroureterectomy (RNU) is the main treatment for high-risk upper tract urothelial cancer (UTUC), but the best technique for reducing intravesical recurrence (IVR) remains uncertain.
  • A systematic review of 31 studies found that early ligation of the ureter and intravesical bladder cuff removal significantly reduce IVR rates, while laparoscopic RNU is associated with higher rates of IVR compared to open RNU.
  • The study suggests that open RNU with early ureter ligation and intravesical cuff removal may provide better outcomes, but further research is needed to determine the best surgical approach, particularly with post-operative chemotherapy.
View Article and Find Full Text PDF

Background And Objective: This publication represents a summary of the updated 2024 European Association of Urology (EAU) guidelines for non-muscle-invasive bladder cancer (NMIBC), TaT1, and carcinoma in situ. The information presented herein is limited to urothelial carcinoma, unless specified otherwise. The aim is to provide practical recommendations on the clinical management of NMIBC with a focus on clinical presentation.

View Article and Find Full Text PDF