Publications by authors named "Ottavio De Cobelli"

Objectives: To examine critical care therapy rates after cytoreductive nephrectomy in metastatic kidney cancer patients.

Design, Setting, And Patients: Relying on the National Inpatient Sample (2000-2019), we addressed critical care therapy use (total parenteral nutrition, invasive mechanical ventilation, renal replacement therapy, percutaneous endoscopic gastrostomy tube insertion, and tracheostomy) and in-hospital mortality in surgically treated metastatic kidney cancer patients. Estimated annual percentage changes and multivariable logistic regression models were fitted.

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To test for rates of inpatient palliative care (IPC) in metastatic testicular cancer patients receiving critical care therapy (CCT). Within the Nationwide Inpatient Sample (NIS) database (2008-2019), we tabulated IPC rates in metastatic testicular cancer patients receiving CCT, namely invasive mechanical ventilation (IMV), percutaneous endoscopic gastrostomy tube (PEG), dialysis for acute kidney failure (AKF), total parenteral nutrition (TPN) or tracheostomy. Univariable and multivariable logistic regression models addressing IPC were fitted.

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Survival differences in rare histological prostate cancer (PCa) subtypes relative to age-matched population-based controls are unknown. Within Surveillance, Epidemiology, and End Results database (2004-2020), newly diagnosed (2004-2015) PCa patients were identified. Relying on the Social Security Administration Life Tables (2004-2020) with 5 years of follow-up, age-matched population-based controls (Monte Carlo simulation) were simulated for each patient.

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Introduction: Benign prostatic hyperplasia (BPH) is a common urological disease that is strongly associated with the aging process and can lead to lower urinary tract symptoms (LUTS). LUTS due to BPH can significantly affect the quality of life of many patients. Among the treatments available for BPH to improve symptoms and functional outcomes, drug therapy and surgical therapy are the options of choice.

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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.
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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.

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Objective: This study aimed to compare adverse in-hospital outcomes in ileal conduit versus neobladder urinary diversion type after radical cystectomy (RC) in contemporary versus historical patients.

Methods: Patients were identified within the National Inpatient Sample (NIS 2000-2019). Propensity score matching (PSM; 1:2 ratio) and multivariable logistic regression models (LRMs) were used.

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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.
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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.

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Background: The aim of this study was to validate lymphovascular invasion (LVI) as a predictor of lymph-node invasion (LNI) in squamous cell carcinoma of the penis (SCCP).

Methods: Within the Surveillance, Epidemiology, and End Results database (2010-2020), we identified SCCP patients who underwent lymphadenectomy with known LVI status. Univariable logistic regression models (LRMs) addressed LNI.

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Objective: To quantify the differences in 5-year overall survival (OS) between high-grade (Gleason sum 8-10) incidental prostate cancer (IPCa) patients and age-matched male population-based controls, according to treatment type: no active versus active treatment.

Materials And Methods: We relied on the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015) to identify not actively treated and actively treated high-grade IPCa patients. For each case, we simulated an age-matched male control (Monte Carlo simulation), relying on Social Security Administration Life Tables (2004-2020) with 5 years of follow-up.

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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.

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Background/objectives: Solitary fibrous tumors (SFTs) represent a rare mesenchymal malignancy that can occur anywhere in the body. Due to the low prevalence of the disease, there is a lack of contemporary data regarding patient demographics and cancer-control outcomes.

Methods: Within the SEER database (2000-2019), we identified 1134 patients diagnosed with malignant SFTs.

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Article Synopsis
  • - The study investigates the relationship between surgical resection and cancer-specific mortality (CSM) in patients with soft tissue pelvic sarcomas, focusing on different histologic subtypes such as liposarcoma, leiomyosarcoma, and sarcoma NOS, using data from the SEER database.
  • - Analysis of 2,491 patients reveals that liposarcoma is the most prevalent subtype, with high surgical resection rates in non-metastatic cases (92% for liposarcoma), and those who had surgery showed lower CSM rates compared to those who did not.
  • - The findings indicate that surgical resection generally offers a protective benefit against CSM in non-metastatic patients across histologic sub
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Article Synopsis
  • Monkeypox is a viral disease caused by the Monkeypox virus, which starts in animals and can spread to humans.
  • Historically, it was mostly found in central and west Africa, but it has recently expanded to multiple regions around the world.
  • This spread has raised significant concerns for global health authorities as they work to manage and contain the virus.
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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.

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Objective: To conduct a comprehensive comparison of microwave ablation (MWA) vs radiofrequency ablation (RFA) outcomes in the treatment of small renal masses (SRMs), specifically: TRIFECTA ([i] complete ablation, [ii] absence of Clavien-Dindo Grade ≥III complications, and [iii] absence of ≥30% decrease in estimated glomerular filtration rate) achievement, operative time (OT), and local recurrence rate (LRR).

Patients And Methods: We retrospectively analysed 531 patients with SRMs (clinical T1a-b) treated with MWA or RFA at a single centre (2008-2022). First, multivariable logistic regression models were used for testing TRIFECTA achievement.

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Article Synopsis
  • The study aimed to compare 10-year overall survival rates of patients with intermediate/high-risk non-metastatic clear cell renal carcinoma, who underwent radical nephrectomy, to matched controls based on age and sex, while also examining differences by race/ethnicity.
  • Using data from the SEER database, researchers identified nearly 7,000 patients and found that overall survival rates after 10 years were notably lower for African American patients compared to controls (51% vs. 81%), with similar patterns observed for other racial/ethnic groups.
  • The findings suggest that radical nephrectomy patients have poorer survival compared to the general population, with African Americans showing a significantly higher risk of mortality from
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Background: Prostate cancer (PCa) is a highly heterogeneous disease, making tailored treatment approaches challenging. Magnetic resonance imaging (MRI), notably diffusion-weighted imaging (DWI) and the derived Apparent Diffusion Coefficient (ADC) maps, plays a crucial role in PCa characterization. In this context, radiomics is a very promising approach able to disclose insights from MRI data.

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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).

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Purpose: We investigated regional differences in patients with stage III nonseminoma germ cell tumor (NSGCT). Specifically, we investigated differences in baseline patient, tumor characteristics and treatment characteristics, as well as cancer-specific mortality (CSM) across different regions of the United States.

Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database (2004-2018), patient (age, race/ethnicity), tumor (International Germ Cell Cancer Collaborative Group [IGCCCG] prognostic groups) and treatment (systemic therapy and retroperitoneal lymph dissection [RPLND] status) characteristics were tabulated for stage III NSGCT patients, according to 12 SEER registries representing different geographic regions.

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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).

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Introduction: Leukemia history affects some radical prostatectomy (RP) patients. Although its prevalence and effect as an adverse risk factor are well known in cardiac surgery, the number of RP patients with a leukemia history, as well as their rate of adverse in-hospital outcomes, are unknown.

Methods: We identified RP patients (National Inpatient Sample 2000-2019), stratified according to the presence or absence of a leukemia history.

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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.

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