Publications by authors named "Simone Morra"

Introduction: To test for cancer specific mortality (CSM) differences after either radical prostatectomy (RP) or radiotherapy (RT) in incidental prostate cancer (IPCa) patients.

Patients And Methods: Within the Surveillance, Epidemiology, and End Results (SEER) database (2004-2015), IPCa patients were identified. Cumulative incidence plots as well as competing risks regression (CRR) models were fitted to address CSM after adjustment for other-cause mortality (OCM).

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Muscle-invasive bladder cancer and subsequent radical cystectomy with ureterocutaneostomy significantly impact patients' body image and quality of life, potentially increasing the risk of adverse mental health outcomes. Acceptance may represent a psychosocial resource to buffer the effects of body image impairment on health, thereby supporting stoma adjustment and preserving quality of life. This study aimed to investigate the mediating role of stoma acceptance in the relationship between body image distress and mental health.

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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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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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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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The aim of the current review was to elucidate the clinical context and presentation of sexual dysfunction (SD) and gynecomastia in rheumatological patients undergoing methotrexate treatment. Moreover, we aimed also to make physicians aware of the occurrence of these side effects, to adequately inform the patient before starting treatment. : Systematic review (PROSPERO id: CRD42022358275) was performed according to preferred reporting items for systematic reviews and meta-analyses.

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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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Background: Overactive bladder (OAB) is a chronic condition. This study was prompted by the need to fill the gap between medical treatment and advanced therapies allowing improvement in Quality of Life. The aim of the current study was to evaluate the association between treatment type (Ialuril; IBSA Farmaceutici, Lodi, Italy; in combination with antimuscarinic or alone after drop-out of antimuscarinic, relative to antimuscarinic alone treatment) and functional outcomes (number of micturitions, pelvic pain, urinary incontinence, nocturia, urgency).

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  • Robotic surgery allows for precise tissue control but often leads to significant drops in hemoglobin (Hb) levels after procedures like robot-assisted radical prostatectomy (RARP) for prostate cancer.
  • A study analyzed Hb changes and potential predictive factors in 110 patients who underwent RARP, finding a notable Hb drop from a median of 14.6 g/dl pre-surgery to 12.7 g/dl by postoperative day one, with stabilization occurring shortly afterward.
  • Multivariable analyses showed that factors like age, BMI, and intraoperative variables did not significantly predict the extent of Hb drop, suggesting that other management strategies may be important for postoperative care.
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Article Synopsis
  • The surgical training landscape is shifting from traditional methods to more scientific ones, particularly in robot-assisted surgeries like radical prostatectomy (RARP), to enhance safety and efficiency.
  • The review highlights a lack of standardized curricula for RARP training, despite the increasing adoption of robotic surgery and its associated risks, underscoring the need for structured training programs.
  • Various training stages, including e-learning, virtual simulators, and hands-on labs, are essential to equip surgeons with the unique skills needed for successful robotic surgeries.
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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.

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On-clamp partial nephrectomy for the surgical treatment of renal masses poses the risk of ischemia and greater post-operative renal function loss. Conversely, the off-clamp technique might enhance renal function preservation by avoiding any ischemia time. Nevertheless, the debate persists regarding the efficacy of the on- versus off-clamp partial nephrectomy in achieving better surgical, functional, and oncological outcomes.

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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.
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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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To test the impact of the prostate-gland asymmetry on continence rates, namely 3- and 12-month continence recovery, in prostate cancer (PCa) patients who underwent robot-assisted radical prostatectomy (RARP). Within our institutional database, RARP patients with complete preoperative MRI features and 12 months follow-up were enrolled (2021-2023). The population has been stratified according to the presence or absence of prostate-gland asymmetry (defined as the presence of median lobe or side lobe dominance).

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Background: The purpose of this study was to test for survival differences according to adjuvant chemotherapy (AC) status in radical nephroureterectomy (RNU) patients with pT2-T4 and/or N1-2 upper tract urothelial carcinoma (UTUC).

Patients And Methods: Within the Surveillance, Epidemiology, and End Results database (SEER, 2007-2020), patients with UTUC treated with AC versus RNU alone were identified. Kaplan-Meier plots and multivariable Cox regression models addressed cancer-specific mortality (CSM).

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The management of ureter hydronephrosis and urolithiasis during pregnancy has been changed by the adoption of ureteric stents. Despite their broad use for several other conditions, from emergency to elective settings, their complications cannot be ignored. Being most prevalent during pregnancy, urinary tract infections and stent encrustations are particularly common and can affect either fetal growth or maternal-fetal homeostasis, leading to obstetric complications.

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Background: It is unknown whether 5-year overall survival (OS) differs and to what extent between the American Joint Committee on Cancer stage III non-seminoma testicular germ cell tumor (NS-TGCT) patients and simulated age-matched male population-based controls, according to race/ethnicity groups.

Methods: We identified newly diagnosed (2004-2014) stage III NS-TGCT patients within the Surveillance Epidemiology and End Results database 2004-2019. For each case, we simulated an age-matched male control (Monte Carlo simulation), relying on Social Security Administration (SSA) Life Tables with 5 years of follow-up.

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Objective: New indices of dyslipidemia, such as the Atherogenic Index of Plasma (AIP) or Castelli Risk Index I and II (CR-I/II), have been tested to predict erectile dysfunction (ED). The aim of this study was to assess the role of these lipidic scores in predicting severe ED and erectile function (EF) worsening in patients who underwent robot-assisted radical prostatectomy (RARP).

Methods: Data from 1249 prostate cancer patients who underwent RARP at our single tertiary academic referral center from September 2021 to April 2023 were reviewed.

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Article Synopsis
  • The study explores the impact of new treatment paradigms on overall survival (OS) for patients with clear-cell metastatic renal cell carcinoma (ccmRCC), comparing data from 2017-2020 to 2010-2016.
  • Contemporary patients showed a median OS of 41 months, significantly better than 25 months for historical patients, indicating a 16-month improvement.
  • Advanced treatments from phase III trials appear to be successfully integrated into general practice, benefiting patients across different treatment types (systemic therapy, cytoreductive nephrectomy, or both).
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  • Using enzymes instead of rare metals to generate hydrogen is a promising area in biochemistry, focusing on sustainability with hydrogen production.
  • The oxygen sensitivity of the fastest hydrogen-generating enzymes (like [FeFe]hydrogenases) limits their use, leading researchers to explore slower but more robust [NiFe] enzymes.
  • Recent studies have identified clostridial enzymes that can withstand oxygen damage, opening up new applications in biofuels and biotechnology, as well as potential improvements through engineered variants for better performance.
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Background: It is unknown whether the stage of the primary may influence the survival (OS) of metastatic upper tract urothelial carcinoma (mUTUC) patients treated with nephroureterectomy (NU) and systemic therapy (ST). We tested this hypothesis within a large-scale North American cohort.

Methods: Within Surveillance Epidemiology and End Results database 2000-2020, all mUTUC patients treated with ST+NU or with ST alone were identified.

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Article Synopsis
  • The study investigates the role of sarcomatoid dedifferentiation as a predictor of cancer-specific mortality (CSM) in patients with localized high-grade clear-cell renal cell carcinoma who underwent surgery.
  • The data analyzed from the Surveillance, Epidemiology, and End Results database included nearly 19,000 patients, revealing a significant difference in 5-year CSM-free survival rates based on the presence of sarcomatoid dedifferentiation.
  • The results indicate that sarcomatoid dedifferentiation acts as an independent risk factor for higher CSM and interacts with tumor grade, enhancing the prediction of mortality risk among patients.
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