Publications by authors named "Pier-Paolo Avolio"
This article equips Canadian urologists with the latest advancements in focal therapy (FT) principles and outcomes while providing an overview of its current landscape in Canada, including challenges and future directions. We conducted a nonsystematic review of the literature on FT in urology and prostate cancer (PCa), focusing on Canadian-led studies. Articles were identified using PubMed, MEDLINE, and Google Scholar and selected based on relevance and originality.
View Article and Find Full Text PDFMultiparametric 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.
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- 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
- 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.
Purpose: To compare the oncologic outcomes of patients with nonmetastatic muscle-invasive bladder cancer (MIBC) undergoing complete versus incomplete transurethral tumor resection (TURBT) before radiation therapy.
Methods And Materials: Patients with nonmetastatic MIBC who underwent curative-intent radiation therapy between 2002 and 2018 at 10 Canadian institutions were retrospectively evaluated. Inverse probability of treatment weighting was performed using baseline characteristics.
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 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
Article Synopsis
- A systematic review and meta-analysis examined the differences between open radical cystectomy (ORC) and robot-assisted radical cystectomy (RARC) by evaluating data from several randomized controlled trials (RCTs) regarding patient outcomes.
- The primary focus was on health-related quality of life (QoL) after surgery, with findings showing no significant differences in QoL, complication rates, or oncological outcomes between the two methods at 3 and 6 months post-surgery.
- RARC had advantages in transfusion rates but required longer operative times and incurred higher costs, making both procedures viable options for treating bladder cancer.
: to investigate the impact of age on renal function deterioration after robotic-assisted partial nephrectomy (RAPN) focusing on a decline to moderate and severe forms of chronic kidney disease (CKD). : This is a single center prospective analysis of patients who underwent RAPN. The outcomes include the development of de novo CKD-S 3a [estimated glomerular filtration rate (eGFR) < 60 mL/min/1.
View Article and Find Full Text PDFBackground: The diagnostic process for prostate cancer after a negative biopsy is challenging. This study compares the diagnostic accuracy of micro-ultrasound (mUS) with multiparametric magnetic resonance imaging (mpMRI) for such cases.
Methods: A retrospective cohort study was performed, targeting men with previous negative biopsies and using mUS and mpMRI to detect prostate cancer and clinically significant prostate cancer (csPCa).
Objectives: To develop a microultrasound-based nomogram including clinicopathological parameters and microultrasound findings to predict the presence of extra-prostatic extension and guide the grade of nerve-sparing.
Material And Methods: All patients underwent microultrasound the day before robot-assisted radical prostatectomy. Variables significantly associated with extra-prostatic extension at univariable analysis were used to build the multivariable logistic model, and the regression coefficients were used to develop the nomogram.
Article Synopsis
- Scientists wanted to see how well two types of prostate cancer tests worked for men who had suspicious signs during exams and scans.
- They found that using microultrasound-targeted biopsy (microUSTBx) with systematic biopsy (SBx) found cancer just as well as another method called mpMRI with targeted biopsy (MTBx).
- This new method not only helped find cancer accurately but also prevented many unnecessary tests, making it a better choice for some patients.
Unlabelled: Abstract.
Objective: The aim of this study is to evaluate male awareness of developing prostate cancer (PCa) in families with germline DNA-repair genes (DRG) variants.
Materials And Methods: Data were collected from a prospective, monocentric cohort study.
Purpose: Micro-UltraSound (microUS) is a new imaging modality capable of identifying and targeting suspicious areas, which might further increase the diagnostic yield of prostate biopsy (PBx). Aim of this review is to provide insights into the usefulness of microUS for the sub-stratification of prostate cancer (PCa), clinically significant PCa (i.e.
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- The study checks how well different types of biopsies (tests to check for prostate cancer) work in men with specific MRI findings called PI-RADS 5.
- It compares a combined method of targeted biopsy (CTBx) with another method that includes a regular biopsy (SBx) to see which one finds more cases of prostate cancer.
- The results suggest that the combined method is just as good at finding cancer, and it can avoid a lot of unnecessary regular biopsies, making it a better option for patients.
Liquid biopsy (LB) for prostate cancer (PCa) detection could represent an alternative to biopsy. Seminal fluid (SF) is a source of PCa-specific biomarkers, as 40% of ejaculate derives from the prostate. We tested the feasibility of an SF-based LB by evaluating the yield of semen self-sampling in a cohort of >750 patients with clinically localized PCa.
View Article and Find Full Text PDFBackground: T1 high-grade (HG) non-muscle invasive bladder cancer (NMIBC) has a significant risk of recurrence and progression, and the European Association of Urology recommends a second transurethral resection of the bladder (ReTUR). Stage at ReTUR has been shown to be a reliable predictor of survival, therefore, we sought to assess clinical and pathological predictors associated with the persistence of T1 at ReTUR in our retrospective multicentric cohort.
Methods: This is a retrospective multicentric study of T1 HG patients at transurethral resection of the bladder (TURB) who underwent subsequent ReTUR.
Article Synopsis
- Active surveillance (AS) is a common approach for managing low-risk prostate cancer, but identifying candidates for AS is difficult; this study investigates the effectiveness of microultrasound (microUS) in conjunction with mpMRI for monitoring these patients.
- A total of 100 prostate cancer patients underwent TRUS with microUS and targeted biopsies, revealing that 34 patients were upgraded to more significant disease at confirmatory biopsies, highlighting microUS's role in identifying clinically relevant cancer.
- The findings indicate that both microUS and mpMRI are highly sensitive tools for detecting clinically significant prostate cancer, which could improve decision-making in the management of patients undergoing active surveillance.
We aim to evaluate the potential protective role of intravesical Bacillus Calmette-Guerin (BCG) against SARS-CoV-2 in patients with non-muscle invasive bladder cancer (NMIBC). Patients treated with intravesical adjuvant therapy for NMIBC between January 2018 and December 2019 at two Italian referral centers were divided into two groups based on the received intravesical treatment regimen (BCG vs. chemotherapy).
View Article and Find Full Text PDFPatients with pT1 high-grade (HG) urothelial carcinoma (UC) and a very high risk of progression might benefit from immediate radical cystectomy (RC), but this option remains controversial. Validation of a standardized method to evaluate the extent of lamina propria (LP) invasion (with recognized prognostic value) in transurethral resection (TURBT) specimens is still needed. The Rete Oncologica Lombarda (ROL) system showed a high predictive value for progression after TURBT in recent retrospective studies.
View Article and Find Full Text PDFBackground: Multiparametric magnetic resonance imaging (mpMRI) is an invaluable diagnostic tool in the decision-making for prostate biopsies (PBx). However, a non-negligible proportion of patients with negative MRI (nMRI) may still harbour prostate cancer (PCa).
Objective: To assess whether microultrasound (micro-US) can help in substratifying the presence of PCa and clinically significant PCa (csPCa; ie, any Gleason score ≥7 PCa) in patients with nMRI despite a persistently high clinical suspicion of PCa.
Article Synopsis
- The study looked at how a specific genetic change (T2:ERG) could be linked to imaging scores used to check for prostate cancer (PCa).
- It involved 158 men who were suspected of having PCa and who underwent biopsies to confirm the diagnosis.
- The results showed that a majority of the patients had PCa, and combining the genetic test with imaging scores improved the ability to accurately diagnose clinically significant prostate cancer.
Introduction: To externally validate and directly compare the performance of the Briganti 2012 and Briganti 2019 nomograms as predictors of lymph node invasion (LNI) in a cohort of patients treated with robot-assisted radical prostatectomy (RARP) and extended pelvic lymph node dissection (ePLND).
Materials And Methods: After the exclusion of patients with incomplete biopsy, imaging, or clinical data, 752 patients who underwent RARP and ePLND between December 2014 to August 2021 at our center, were included. Among these patients, 327 (43.