Publications by authors named "Mario DE Angelis"
Purpose: The utility of a pelvic drain (PD) after robot-assisted radical prostatectomy (RARP) has been recently questioned. We investigated the impact of discontinuing PD placement after RARP on complications, pain, environmental benefits, and cost savings.
Methods: We identified 1,199 patients who underwent RARP with or without extended pelvic lymph node dissection from 2016 to 2023 at a referral center.
Purpose: Temporal trends in and predictors of inpatient palliative care use in patients with metastatic renal cell carcinoma (mRCC) undergoing critical care therapy are unknown.
Methods: Relying on the National Inpatient Sample (2008-2019), we identified mRCC patients undergoing critical care therapy, namely invasive mechanical ventilation, percutaneous endoscopic gastrostomy tube insertion, dialysis for acute kidney failure, total parenteral nutrition, or tracheostomy. Estimated annual percentage changes (EAPC) analyses and multivariable logistic regression models addressed inpatient palliative care use.
Background: The role of primary tumor ablation (pTA) in metastatic renal cell carcinoma (mRCC) is unknown. We compared pTA-treated mRCC patients to patients who underwent no local treatment (NLT), as well as patients who underwent cytoreductive nephrectomy (CN).
Methods: Within the Surveillance, Epidemiology, and End Results database (SEER, 2004-2020), we identified mRCC patients who underwent either pTA, NLT or CN.
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).
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.
Objective: To describe the initial experience with PSMA-PET/CT-guided biopsy in European referral centres.
Methods: This multicenter observational cohort study was endorsed by the Young Academic Urologist (YAU) Prostate Cancer Group of the EAU and conducted across 6 tertiary-level European centres. PSMA-guided biopsies were carried out in a cognitive/fusion manner for all the recruited patients with or without MRI-guided biopsies and/or standard biopsy (SB).
Introduction: Neoadjuvant chemotherapy (NAC) before radical cystectomy (RC) is guideline-recommended in patients with cT2-T4N0M0 urothelial carcinoma of urinary bladder (UCUB). However, no population-based study validated the survival benefit of NAC recorded in clinical trials in a stage-specific fashion. We addressed this knowledge gap.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the use of critical care therapies (CCT) like invasive mechanical ventilation and total parenteral nutrition in patients following radical nephroureterectomy for upper urinary tract carcinoma, revealing an unclear relationship with in-hospital mortality.
- An analysis of 8,995 non-metastatic UUTC patients from 2008-2019 found that 4.2% received CCT, with a notable correlation between the rates of CCT and in-hospital mortality over time.
- Findings suggest that CCT is more common among older and sicker patients, while a decline in CCT and mortality rates indicates improvements in care quality, with an ideal scenario showing that in-hospital deaths should follow CCT exposure.
Article Synopsis
- This study looked at how paraplegia affects risks during and after surgery for bladder cancer.
- Out of over 25,000 patients, very few (185) were paraplegic, and they had more complications and higher death rates after surgery compared to people without paraplegia.
- The findings suggest that doctors should inform paraplegic patients about the increased risks before they undergo surgery for bladder cancer.
Article Synopsis
- This study looked at two types of cancer treatment: Trimodal Therapy (TMT) and External Beam Radiation Therapy (EBRT) for bladder cancer patients.
- It found that TMT helped more patients live longer compared to EBRT, especially in those with earlier stages of cancer.
- However, TMT didn't show a survival advantage in patients with more advanced cancer stages.
Background: The use of inpatient palliative care (IPC) in advanced cancer patients represents a well-established guideline recommendation. This study examines the utilization rates and patterns of IPC among patients with metastatic adrenocortical carcinoma (mACC).
Methods: Relying on the Nationwide Inpatient Sample database (2007-2019), we tabulated IPC rates in mACC patients.
Article Synopsis
- This study analyzed the clinicopathologic characteristics and treatment patterns of adult prostate sarcoma patients using data from the Surveillance, Epidemiology, and End Results database between 2004 and 2020.
- Among 125 patients, the most common subtype was leiomyosarcoma (36%), with rhabdomyosarcoma (14%) being more likely to present at a metastatic stage compared to other types.
- The overall median survival was 27 months, with treatment approaches differing significantly based on the subtype; metastatic disease was linked to higher mortality rates, while stromal sarcoma had a lower overall mortality risk.
Article Synopsis
- Complete surgical resection (adrenalectomy) is the only potential cure for metastatic adrenocortical carcinoma (mACC), but its impact on survival rates has been unclear.
- A study using the SEER database from 2004 to 2020 analyzed the effects of adrenalectomy on the survival of mACC patients and found that those who underwent the surgery had significantly lower mortality rates.
- The results indicated that while adrenalectomy benefits many, its effectiveness may vary based on factors like the type of systemic therapy received and the number of metastatic sites.
Race/Ethnicity Affects Access and Survival Differences After Neoadjuvant or Adjuvant Chemotherapy at Radical Cystectomy in Urothelial Carcinoma Patients.
J Racial Ethn Health Disparities
August 2024
Introduction: It is unknown whether race/ethnicity affects access and/or survival after neoadjuvant (NAC) or adjuvant chemotherapy (ADJ) at radical cystectomy (RC). We addressed these knowledge gaps.
Material And Methods: Within the Surveillance, Epidemiology, and End Results database (2007-2020), we identified NAC candidates (T2-T4N0M0) and ADJ candidates (T3-T4 and/or N1-3).
Purpose: To quantify to what extent the 5-year overall survival (OS) of adrenocortical carcinoma (ACC) patients differs from age- and sex-matched population-based controls, especially when stage is considered.
Methods: We relied on the Surveillance, Epidemiology, and End Results database (2004-2020) to identify newly diagnosed (2004-2014) ACC patients. Subsequently, we compared OS between ACC patients relative to simulated age- and sex-matched controls (Monte Carlo simulation), according to Social Security Administration Life Tables (2004-2020).
Objective: Systemic therapy is guideline-recommended for metastatic urothelial carcinoma of the urinary bladder (UCUB). Unmarried status represents an important barrier to treatment access in many primaries. The importance of married status is unknown in the context of systemic therapy in metastatic UCUB and was addressed in the current study.
View Article and Find Full Text PDFBackground: Induction followed by 1 year maintenance instillation of intravesical Bacillus Calmette-Guerin (BCG) is the standard treatment for intermediate-risk (IR) nonmuscle invasive bladder cancer (NMIBC) patients. Few data exist on the efficacy of Mitomycin C (MMC) instillation in this setting.
Methods: We retrospectively analyzed 226 IR-NMIBC patients classified by the International Bladder Cancer Group (IBCG) and 250 IR-NMIBC intravescical treatment-naïve patients classified by the European Association of Urology (EAU).