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Oderda M, Grimaldi S, Rovera G, Delsedime L, D'Agate D, Lavagno F, Marquis A, Marra G, Molinaro L, Deandreis D, Gontero P. Robot-assisted PSMA-radioguided Surgery to Assess Surgical Margins and Nodal Metastases in Prostate Cancer Patients: Report on Three Cases Using an Intraoperative PET-CT Specimen Imager. Urology 2023; 182:e257-e261. [PMID: 37669707 DOI: 10.1016/j.urology.2023.08.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 09/07/2023]
Abstract
INTRODUCTION The aim of this feasibility study was to test the intraoperative use of this brand-new specimen PET/CT to guide robot-assisted radical prostatectomy and pelvic lymph node dissection. MATERIALS AND METHODS Three cases of robot-assisted radical prostatectomy and pelvic lymph node dissection were performed with intraoperative use of the specimen imager. Surgeries were performed with Da Vinci Xi robot. An intravenous injection of 68Ga-PSMA-11 was performed in the OR and after complete excision, the specimens were analyzed with the imager. RESULTS The average nodal yield was 17.3 (5.8 SD) nodes per patient. Specimen PET/CT images showed a focal uptake in a metastatic node (TBR 13.6), and no uptake or diffuse, faint uptake in negative nodes (TBR range: 1-5.3). The specimen imager provided intraoperative PET/CT images that clearly showed negative surgical margins in two patients, whereas the results were uncertain in a locally advanced case. CONCLUSION The intraoperative use of the specimen PET/CT imager is safe and feasible and could improve the evaluation of prostate surgical margins and lymph node status.
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Affiliation(s)
- Marco Oderda
- Department of Surgical Sciences, Urology Unit, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy.
| | - Serena Grimaldi
- Nuclear Medicine, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Guido Rovera
- Nuclear Medicine, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Luisa Delsedime
- Department of Pathology, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - Daniele D'Agate
- Department of Surgical Sciences, Urology Unit, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - Federico Lavagno
- Department of Surgical Sciences, Urology Unit, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - Alessandro Marquis
- Department of Surgical Sciences, Urology Unit, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - Giancarlo Marra
- Department of Surgical Sciences, Urology Unit, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - Luca Molinaro
- Department of Pathology, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
| | - Desireé Deandreis
- Nuclear Medicine, Department of Medical Sciences, AOU Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
| | - Paolo Gontero
- Department of Surgical Sciences, Urology Unit, AOU Città della Salute e della Scienza di Torino, Molinette Hospital, University of Turin, Turin, Italy
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Falcone M, Preto M, Ferro I, Cirigliano L, Peretti F, Plamadeala N, Scavone M, Lavagno F, Oderda M, Gontero P. Surgical and Functional Outcomes of Penile Amputation and Perineal Urethrostomy Configuration in Invasive Penile Cancer. Urology 2023; 177:227. [PMID: 37085051 DOI: 10.1016/j.urology.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVE The treatment of invasive penile cancer is based on partial or total penectomy and perineal urethrostomy configuration.1-3 To report surgical and functional outcomes of penile amputation and perineal urethrostomy configuration in a consecutive series of patients with invasive penile cancer. MATERIALS AND METHODS A single-center retrospective analysis was conducted from January 2018 to December 2022. Data were extracted from clinical records and operative notes. As primary outcomes, surgical complications were described. Oncological outcomes through cancer-specific survival and overall survival were analyzed. Patient survival was estimated by a Kaplan-Meier analysis. Functional outcomes were assessed through the administration of the International Prostatic Symptoms Score (IPSS) questionnaire at 3 months follow-up. RESULTS Overall 10 patients were enrolled. The median follow-up was 16 months (Interquartile range (IQR 12-18)). The median age was 71 years (IQR 63-79). Operative time was set at 195 minutes (IQR 155-275). The median hospital stay was 8 days (IQR: 6-10). Postoperative complications occurred in 20% of patients, in 1 case surgical revision was necessary. Positive surgical margins were detected only in 1 patient. The median catheterization time was 15 days (IQR: 15-32). One patient developed local recurrence. At 1 year, the cancer-specific survival was 80% and overall survival was 60%. The median preoperative IPSS was 15 (IQR 12-19). The median postoperative IPSS was 6 (IQR 5-7). CONCLUSION Penile amputation and perineal urethrostomy configuration was demonstrated to be a safe and effective procedure to address invasive penile cancer.
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Affiliation(s)
- Marco Falcone
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Mirko Preto
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy.
| | - Ilaria Ferro
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Lorenzo Cirigliano
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Federica Peretti
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Natalia Plamadeala
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Martina Scavone
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Federico Lavagno
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Marco Oderda
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy
| | - Paolo Gontero
- Department of Urology, A.O.U. Città della Salute e della Scienza, Turin, Italy
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Falcone M, Preto M, Ferro I, Lavagno F, Cirigliano L, Peretti F, Plamadeala N, Timpano M, Ceruti C, Gontero P. Subtotal penectomy and perineostomy configuration in locally advanced penile cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01417-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Lavagno F, De Bellis M, Vitiello F, Sibona M, Marra G, Calleris G, Vignola A, Mangione C, Allasia M, Soria F, Gontero P. 3D virtual models in planning kidney cancer surgery: Impact on surgical technique in Padua >= 8 masses scheduled for NSS. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00110-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gontero P, Oderda M, Calleris G, Allasia M, Agnello M, Rampa P, Soria F, Lavagno F, Mazzoli S, De Bellis M, Vitiello F, Brazzi L, Balagna R, Gobbi F. First ever reported case of continuous spinal anesthesia da Vinci robotic partial nephrectomy. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01274-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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