Perioperative outcomes, environmental impact and economic implications of pelvic drain discontinuation in prostate cancer patients undergoing robot-assisted radical prostatectomy.

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.

Wearables for Health (W4H) Toolkit for Acquisition, Storage, Analysis and Visualization of Data from Various Wearable Devices.

The Wearables for Health Toolkit (W4H Toolkit) is an open-source platform that provides a robust, end-to-end solution for the centralized management and analysis of wearable data. With integrated tools and frameworks, the toolkit facilitates seamless data acquisition, integration, storage, analysis, and visualization of both stored and streaming data from various wearable devices. The W4H Toolkit is designed to provide medical researchers and health practitioners with a unified framework that enables the analysis of health-related data for various clinical applications.

Defining the optimal target-to-background ratio to identify positive lymph nodes in prostate cancer patients undergoing robot-assisted [Tc]Tc-PSMA radioguided surgery: updated results and ad interim analyses of a prospective phase II study.

Introduction: Prostate-specific membrane antigen radioguided surgery (PSMA-RGS) might identify lymph node invasion (LNI) in prostate cancer (PCa) patients undergoing extended pelvic lymph node dissection (ePLND). The optimal target-to-background (TtB) ratio to define RGS positivity is still unknown.

Materials & Methods: Ad interim analyses which focused on 30 patients with available pathological information were conducted.

Use of 18F-fluoro-2-deoxy-d-glucose (18F-FDG) PET/CT for lymph node assessment before radical cystectomy in bladder cancer patients.

Objective: To assess the diagnostic performance of 18F-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomograpy (PET)/computed tomography (CT) in nodal staging before radical cystectomy (RC) and pelvic lymph node dissection (PLND) for bladder cancer (BCa).

Materials And Methods: This analysis was based on a cohort of 199 BCa patients undergoing RC and bilateral PLND between 2015 and 2022. Neoadjuvant chemotherapy (NAC) or immunotherapy (NAI) was administered after oncological evaluation.

Comparative Effectiveness of Neoadjuvant Pembrolizumab Versus Cisplatin-based Chemotherapy or Upfront Radical Cystectomy in Patients with Muscle-invasive Urothelial Bladder Cancer.

Background: Recent progresses in the use of immune checkpoint inhibitor (ICI) have challenged the therapeutic standards in patients with muscle-invasive urothelial bladder carcinoma (MIBC).

Objective: To compare neoadjuvant pembrolizumab followed by radical cystectomy (RC) versus neoadjuvant chemotherapy (NAC) and RC or upfront RC, according to cisplatin eligibility.

Design, Setting, And Participants: We conducted two separate analyses for cisplatin-eligible and cisplatin-ineligible cT2-4N0M0 MIBC patients.

Robot-assisted adrenalectomy: Step-by-step technique and surgical outcomes at a high-volume robotic center.

Objective: In the last years, robotic surgery was introduced in several different settings with good perioperative results. However, its role in the management of adrenal masses is still debated. In order to provide a contribution to this field, we described our step-by-step technique for robotic adrenalectomy (RA) and related modifications according to the type of adrenal mass treated.

Transitioning from Da Vinci Si to Xi: assessing surgical outcomes at a high-volume robotic center.

Purpose: In the emerging field of robotics, only few studies investigated the transition between different robotic platforms in terms of surgical outcomes. We aimed at assessing surgical outcomes of patients receiving robot-assisted radical prostatectomy (RARP) and robot-assisted partial nephrectomy (RAPN) at a high-volume robotic center during the transition from Si to Xi Da Vinci surgical systems.

Methods: We analyzed data of 1884 patients undergoing RARP (n = 1437, 76%) and RAPN (n = 447, 24%) at OLV hospital (Aalst, Belgium) between 2011 and 2021.

Robot-assisted Radical Prostatectomy Performed with Different Robotic Platforms: First Comparative Evidence Between Da Vinci and HUGO Robot-assisted Surgery Robots.

Background: In the field of robotic surgery, there is a lack of comparative evidence on surgical and functional outcomes of different robotic platforms.

Objective: To assess the outcomes of patients receiving robot-assisted radical prostatectomy (RARP) at a high-volume robotic center with daVinci and HUGO robot-assisted surgery (RAS) surgical systems.

Design, Setting, And Participants: We analyzed the data of 542 patients undergoing RARP ± extended pelvic lymph node dissection at OLV hospital (Aalst, Belgium) between 2021 and 2023.

The immune-related adverse events paradox in locally advanced or metastatic urothelial cancer after atezolizumab immunotherapy: analysis of individual patient data from IMvigor210 and IMvigor211 trials.

Objective: To investigate the association between immune-related adverse events (irAEs) and oncological outcomes in patients with advanced urothelial cancer receiving immune checkpoint inhibitors (ICIs), and whether the administration of systemic corticosteroids diminishes therapeutic impact.

Patients And Methods: The association between irAEs occurrence and clinical progression-free survival (PFS), overall survival (OS), and cancer-specific survival (CSS) was tested by means of multivariable Cox or competing-risks regression, when appropriate. Patients experiencing irAEs were further stratified based on systemic corticosteroids administration.

Different approaches for bladder neck dissection during robot-assisted radical prostatectomy: the Aalst technique.

Introduction: Bladder neck dissection is one of the most delicate surgical steps of robotic-assisted radical prostatectomy (RARP) [1, 2], and it may affect surgical margins rate and functional outcomes [3, 4]. Given the relationship between outcomes and surgical experience [5-7], it is crucial to implement a step-by-step approach for each surgical step of the procedure, especially in the most challenging part of the intervention. In this video compilation, we described the techniques for bladder neck dissection utilized at OLV Hospital (Aalst, Belgium).

Outcomes of Robot-assisted Radical Prostatectomy with the Hugo RAS Surgical System: Initial Experience at a High-volume Robotic Center.

Clinical data on robot-assisted radical prostatectomy (RARP) performed with the new Hugo robot-assisted surgery (RAS) system are scarce. We described surgical outcomes of 112 consecutive patients who underwent RARP ± extended pelvic lymph-node dissection (ePLND) at OLV Hospital (Aalst, Belgium) between February and November 2022. The median age was 65 yr (interquartile range [IQR] 60-70) and median preoperative prostate-specific antigen (PSA) was 7.

Robot-assisted sutureless partial nephrectomy for the treatment of fifteen bilateral renal masses in a patient with Von Hippel-Lindau syndrome: a case report from a high-volume robotic center.

Renal cell carcinoma is among major causes of death in patients with Von Hippel-Lindau (VHL) syndrome, and it usually presents with multiple and bilateral lesions that may require multiple renal surgeries. This, in turn, may compromise renal function, resulting in end-stage renal disease. To minimize renal function impairment in these patients, great importance is given to the preservation of functional parenchyma with the use of nephron-sparing techniques.

Predicting the probability of pT3 or higher pathological stage at radical prostatectomy: COVID19-specific considerations.

Background: We tested whether a model identifying prostate cancer (PCa) patients at risk of pT3-4/pN1 can be developed for use during COVID19 pandemic, in order to guarantee appropriate treatment to patients harboring advanced disease patients without compromising sustainability of care delivery.

Methods: Within the Surveillance, Epidemiology and End Results database 2010-2016, we identified 27,529 patients with localized PCa and treated with radical prostatectomy. A multivariable logistic regression model predicting presence of pT3-4/pN1 disease was fitted within a development cohort (n=13,977, 50.

An external validation of the nocera nomogram: Predicting non-organ confined stage of ≥pT3 in cT1 clear cell renal cell carcinoma.

Background: Only one previously published study by Nocera et al. addressed the risk of upstaging to ≥pT3 in cT1 clear cell renal cell carcinoma (ccRCC) by using characteristics of the R.E.

Neoadjuvant Pembrolizumab and Radical Cystectomy in Patients with Muscle-Invasive Urothelial Bladder Cancer: 3-Year Median Follow-Up Update of PURE-01 Trial.

Purpose: The PURE-01 study (NCT02736266) pioneered the neoadjuvant immune-checkpoint inhibitor (ICI) therapy before radical cystectomy (RC) in patients with muscle-invasive urothelial bladder carcinoma (MIBC). We herein present the survival outcomes after a median follow-up of three years.

Patients And Methods: The intention-to-treat (ITT) population included 155 patients.

Impact of Early Dorsal Venous Complex Ligation on Urinary Continence Recovery after Robot-assisted Radical Prostatectomy: Results from a Phase 3 Randomized Controlled Trial.

Background: Whether early ligation of the dorsal venous complex (DVC) might improve recovery of urinary continence (UC) after robot-assisted radical prostatectomy (RARP) has never been investigated in a prospective randomized study.

Objective: To assess whether early DVC ligation might affect UC recovery after RARP.

Intervention: DVC ligation (early vs standard).

Immunotherapy in advanced kidney cancer: an alternative meta-analytic method using reconstructed survival data in case of proportional hazard assumption violation.

Background: With the advent of immuno-oncology compounds in randomized trials, we observe more and more survival curves crossing. From a statistical standpoint this corresponds to violation of the proportional hazard assumption. When this occurs, the hazard ratio from the Cox regression is not reliable as an estimate.

Robot-assisted simple prostatectomy with the novel HUGO™ RAS System: feasibility, setting, and perioperative outcomes.

Robot-assisted simple prostatectomy (RASP) has demonstrated better peri-operative outcomes as compared to open simple prostatectomy. However, RASP is still limited by platform availability and cost-effectiveness issues. The new surgical robots increasing competition may spread the robotic approach also in non-oncological fields.

The effect of race/ethnicity on cancer-specific mortality after salvage radical prostatectomy.

Background: To test the effect of race/ethnicity on cancer-specific mortality (CSM) after salvage radical prostatectomy (SRP).

Material And Methods: We relied on the Surveillance, Epidemiology and End Results database (SEER, 2004-2016) to identify SRP patients of all race/ethnicity background. Univariate and multivariate Cox regression models addressed CSM according to race/ethnicity.

Robot-Assisted Sacropexy with the Novel HUGO Robot-Assisted Surgery System: Initial Experience and Surgical Setup at a Tertiary Referral Robotic Center.

Robotic sacropexy (RSC) emerged in the last years as a valid alternative to the laparoscopic technique. However, the robotic approach is still limited by platform availability and concerns about cost-effectiveness. Recently, new robotic platforms joined the market, lowering the costs and offering the possibility to expand the robotic approach.

Androgen annihilation versus advanced androgen blockage as first line treatment for metastatic castration resistant prostate cancer: A systematic review and meta-analysis.

Background: Despite recent advances in the treatments of metastatic castration resistant prostate cancer (mCRPC), patients' prognosis remains suboptimal and novel treatment combinations are under scrutiny. On this matter, the recent ACIS trial tested the role of abiraterone plus apalutamide (androgen annihilation) in addition to androgen deprivation therapy, versus abiraterone plus androgen deprivation therapy. Herein, we performed a meta-analysis to compare overall survival (OS) and progression free survival (PFS) among patients who received androgen annihilation versus advanced androgen blockage (abiraterone or enzalutamide), in addition to conventional androgen deprivation therapy.