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Basile G, Gallioli A, Territo A, Verri P, Gaya JM, Afferi L, Diana P, Sanz I, Dieguez L, Uleri A, Berquin C, Gavrilov P, Algaba F, Palou J, Breda A. Cumulative morbidity of ureteroscopy for upper tract urothelial carcinoma. Actas Urol Esp 2024:S2173-5786(24)00067-2. [PMID: 38735432 DOI: 10.1016/j.acuroe.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE To assess complications after ureteroscopy (URS) for upper tract urothelial carcinoma (UTUC) management and to assess its postoperative cumulative morbidity burden using the Comprehensive Complication Index (CCI). MATERIALS AND METHODS Single center retrospective study including patients submitted to URS for UTUC suspicion. URSs were both diagnostic and operative. Postoperative complications were recorded according to the EAU Guidelines and graded according to Clavien-Dindo Classification (CDC). The cumulative postoperative morbidity burden developed by patients experiencing multiple events was assessed using the CCI. Multivariable logistic regression (MLR) analyses identified factors independently associated with the development of any grade and major postoperative complications. RESULTS Overall, 360 patients with UTUC suspicion were included with a total of 575 URSs performed. The cumulative number of all postoperative complications recorded was 111. In 86 (15%) procedures, patients experienced at least one postoperative complication, while 25 (4.3%) experienced more than one complication. Of these, 16 (14%) were severe (CDC ≥ IIIa). The most frequent type of complications were urinary (34%), bleeding (30%) and infectious (30%). The higher the CDC grade, the higher the median CCI, with a statistically significant increase in median CCI from CDC II to major complications. Patients who experienced intraoperative complications were at higher risk of developing any grade and major postoperative complications at MLR. CONCLUSIONS Complications after ureteroscopy for UTUC are relatively uncommon events. Patients who experience intraoperative complications are at higher risk of developing postoperative complications. The comprehensive complication index appeared more representative of the cumulative postoperative morbidity rather than the Clavien-Dindo classification.
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Affiliation(s)
- G Basile
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain; Servicio de Urología, IRCCS Hospital San Raffaele, Milán, Italy.
| | - A Gallioli
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Territo
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - P Verri
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain; Servicio de Urología, Universidad de Turín, Turín, Italy
| | - J M Gaya
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - L Afferi
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - P Diana
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - I Sanz
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - L Dieguez
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Uleri
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain; Servicio de Urología, Universidad Humanitas, Rozzano, Milán, Italy
| | - C Berquin
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain; Servicio de Urología, Hospital Universitario de Gante, Bélgica, Centro acreditado en la Red Europea de Referencia (ERN) eUROGEN, Belgium
| | - P Gavrilov
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - F Algaba
- Área de Anatomía Patológica, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Palou
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Breda
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
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López-Abad A, Piana A, Prudhomme T, Bañuelos Marco B, Dönmez MI, Pecoraro A, Boissier R, Campi R, Breda A, Territo A. Biomarkers in kidney transplantation: Where do we stand? Actas Urol Esp 2024:S2173-5786(24)00003-9. [PMID: 38185319 DOI: 10.1016/j.acuroe.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 10/20/2023] [Indexed: 01/09/2024]
Affiliation(s)
- A López-Abad
- Servicio de Urología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - A Piana
- Servicio de Urología, Hospital San Luigi, Universidad de Turín, Turín, Italy
| | - T Prudhomme
- Servicio de Urología, Trasplante Renal y Andrología, Hospital Universitario de Rangueil, Toulouse, France
| | - B Bañuelos Marco
- Servicio de Urología, Sección de Trasplante Renal y Urología Reconstructiva, Hospital Universitario Clínico San Carlos, Madrid, France
| | - M I Dönmez
- Departamento de Urología, Facultad de Medicina, Universidad de Estambul, Estambul, Turkey
| | - A Pecoraro
- Unidad de Cirugía Robótica Urológica y Trasplante Renal, Universidad de Florencia, Hospital de Careggi, Florencia, Italy
| | - R Boissier
- Servicio de Urología y Trasplante Renal, Hospital Universitario de La Conception, Marsella, France
| | - R Campi
- Unidad de Cirugía Robótica Urológica y Trasplante Renal, Universidad de Florencia, Hospital de Careggi, Florencia, Italy
| | - A Breda
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Territo
- Servicio de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain.
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Piana A, Basile G, Masih S, Bignante G, Uleri A, Gallioli A, Prudhomme T, Boissier R, Pecoraro A, Campi R, Di Dio M, Alba S, Breda A, Territo A. Kidney stones in renal transplant recipients: A systematic review. Actas Urol Esp 2024; 48:79-104. [PMID: 37574010 DOI: 10.1016/j.acuroe.2023.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION Lithiasis in renal graft recipients might be a dangerous condition with a potential risk of organ function impairment. EVIDENCE ACQUISITION A systematic literature search was conducted through February 2023. The primary objective was to assess the incidence of lithiasis in kidney transplant (KT) recipients. The secondary objective was to assess the timing of stone formation, localization and composition of stones, possible treatment options, and the incidence of graft loss. EVIDENCE SYNTHESIS A total of 41 non-randomized studies comprising 699 patients met our inclusion criteria. The age at lithiasis diagnosis ranged between 29-53 years. Incidence of urolithiasis ranged from 0.1-6.3%, usually diagnosed after 12 months from KT. Most of the stones were diagnosed in the calyces or in the pelvis. Calcium oxalate composition was the most frequent. Different treatment strategies were considered, namely active surveillance, ureteroscopy, percutaneous/combined approach, or open surgery. 15.73% of patients were submitted to extracorporeal shock wave lithotripsy (ESWL), while 26.75% underwent endoscopic lithotripsy or stone extraction. 18.03% of patients underwent percutaneous nephrolithotomy whilst 3.14% to a combined approach. Surgical lithotomy was performed in 5.01% of the cases. Global stone-free rate was around 80%. CONCLUSIONS Lithiasis in kidney transplant is a rare condition usually diagnosed after one year after surgery and mostly located in the calyces and renal pelvis, more frequently of calcium oxalate composition. Each of the active treatments is associated with good results in terms of stone-free rate, thus the surgical technique should be chosen according to the patient's characteristics and surgeon preferences.
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Affiliation(s)
- A Piana
- Servicio de Urología, Hospital Romolo, Rocca di Neto, Italy; Departamento de Urología, Universidad de Turín, Turín, Italy.
| | - G Basile
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - S Masih
- Servicio de Urología, Centro Médico de la Universidad de Toledo, Toledo, OH, United States
| | - G Bignante
- Departamento de Urología, Universidad de Turín, Turín, Italy
| | - A Uleri
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - A Gallioli
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - T Prudhomme
- Servicio de Urología, Trasplante Renal y Andrología, Hospital Universitario de Rangueil, Toulouse, France
| | - R Boissier
- Servicio de Urología y Trasplante Renal, Hospital Universitario La Concepción, Marsella, France
| | - A Pecoraro
- Departmento de Medicina Experimental y Clínica, Universidad de Florencia, Florencia, Italy
| | - R Campi
- Departmento de Medicina Experimental y Clínica, Universidad de Florencia, Florencia, Italy
| | - M Di Dio
- Sección de Urología, Servicio de Cirugía, Hospital Annunziata, Cosenza, Italy
| | - S Alba
- Servicio de Urología, Hospital Romolo, Rocca di Neto, Italy
| | - A Breda
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - A Territo
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
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Territo A, Bañuelos Marco B, Breda A, Gómez Rivas J, Dönmez MI. What would be the ideal pathway for a young urologist interested in kidney transplantation? Actas Urol Esp 2023; 47:619-620. [PMID: 37094628 DOI: 10.1016/j.acuroe.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/09/2023] [Indexed: 04/26/2023]
Affiliation(s)
- A Territo
- Department of Urology, Autonoma University of Barcelona, Barcelona, Spain
| | - B Bañuelos Marco
- Department of Urology, Hospital Universitario Clinico San Carlos
| | - A Breda
- Department of Urology, Autonoma University of Barcelona, Barcelona, Spain
| | - J Gómez Rivas
- Department of Urology, Hospital Universitario Clinico San Carlos
| | - M I Dönmez
- Division of Pediatric Urology, Department of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
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Piana A, Pecoraro A, Dönmez MI, Prudhomme T, Bañuelos Marco B, López Abad A, Campi R, Boissier R, Checcucci E, Amparore D, Porpiglia F, Breda A, Territo A. New frontiers in kidney transplantation: Towards the extended reality. Actas Urol Esp 2023:S2173-5786(23)00133-6. [PMID: 37981169 DOI: 10.1016/j.acuroe.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 10/04/2023] [Indexed: 11/21/2023]
Affiliation(s)
- A Piana
- Departmento de Urología, Universidad de Turín, Turín, Italy; Servicio de Urología, Hospital Romolo, Rocca di Neto, Italy.
| | - A Pecoraro
- Departmento de Medicina Experimental y Clínica, Universidad de Florencia, Florencia, Italy
| | - M I Dönmez
- Departmento de Urología, Facultad de Medicina de la Universidad de Estambul, Estambul, Turkey
| | - T Prudhomme
- Servicio de Urología, Trasplante Renal y Andrología, Hospital Universitario de Rangueil, Toulouse, France
| | - B Bañuelos Marco
- Sección de Trasplante Renal y Urología Reconstructiva, Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - A López Abad
- Servicio de Urología, Hospital Clínico Universitario Virgen de la Arrixaca, Murcia, Spain; Departmento de Medicina Experimental y Clínica, Universidad de Florencia, Florencia, Italy
| | - R Campi
- Departmento de Medicina Experimental y Clínica, Universidad de Florencia, Florencia, Italy
| | - R Boissier
- Servicio de Urología y Trasplante Renal, Hospital Universitario La Conception, Marsella, France
| | - E Checcucci
- Servicio de Cirugía, Instituto de Candiolo FPO-IRCCS, Candiolo, Turín, Italy
| | - D Amparore
- Departmento de Urología, Universidad de Turín, Turín, Italy
| | - F Porpiglia
- Departmento de Urología, Universidad de Turín, Turín, Italy
| | - A Breda
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
| | - A Territo
- Unidad de Uro-oncología y Trasplante Renal, Servicio de Urología, Fundación Puigvert, Universidad Autónoma de Barcelona (UAB), Barcelona, Spain
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Territo A, Bajeot AS, Mesnard B, Campi R, Pecoraro A, Hevia V, Piana A, Doumerc N, Breda A, Boissier R, Prudhomme T. Open versus robotic-assisted kidney transplantation: A systematic review by the European Association of Urology (EAU) - Young Academic Urologists (YAU) Kidney Transplant Working Group. Actas Urol Esp 2023; 47:474-487. [PMID: 36965855 DOI: 10.1016/j.acuroe.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 01/24/2023] [Accepted: 01/25/2023] [Indexed: 03/27/2023]
Abstract
INTRODUCTION In the last 20 years, robotic assisted procedures were evaluated in the field of kidney transplantation to provide a mini-invasive approach for this particularly fragile population. As a relatively new issue, few studies compared open kidney transplantation (OKT) and robotic-assisted kidney transplantation (RAKT), mostly in small cohorts. To improve current knowledge, we wanted here to gather comparative data of OKT vs RAKT in a systematic review. METHODS A systematic review was performed according to preferred reporting items for systematic reviews and meta-analyses. Medline, Embase, and Cochrane databases were searched to identify all studies reporting post-operative outcomes of RAKT versus OKT. RESULTS A total of 2136 patients in 13 studies were included. Median recipient age was 42.6 years (OKT: 43.5 years and RAKT: 40.3 years). Median preemptive kidney transplantation rate was 27.1 % (OKT: 23.3 % and RAKT: 33.2 %). Median total operative time and rewarming were respectively: 235 and 49 min in OKT population; 250 and 60 min in RAKT population. Post-operative complications rates were: 26.2 % in OKT population and 17.8 % in RAKT population. Delayed graft function rates were: 4.9 % in OKT population and 2.3 in RAKT population. Mid-term functional outcomes, patient and graft survival were similar in OKT and RAKT population. CONCLUSION This systematic review showed that RAKT may be associated with a lower incidence of delayed graft function and post-operative surgical complications and similar mid-term functional outcomes, patient and graft survival, compared to OKT for end-stage renal disease patients.
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Affiliation(s)
- A Territo
- Uro-oncology and Kidney Transplant Unit, Department of Urology at "Fundació Puigvert" Hospital, Autonoma University of Barcelona, Barcelona, Spain
| | - A S Bajeot
- Department of Urology and Kidney Transplantation, Rangueil University Hospital, Toulouse, France
| | - B Mesnard
- Department of Urology and Kidney Transplantation, Nantes University Hospital, Nantes, France
| | - R Campi
- Department of Urology, Florence University Hospital, Florence, Italy
| | - A Pecoraro
- Department of Urology, Florence University Hospital, Florence, Italy
| | - V Hevia
- Department of Urology, University Hospital Ramón y Cajal, Madrid, Spain
| | - A Piana
- Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Orbassano, Turin, Italy
| | - N Doumerc
- Department of Urology and Kidney Transplantation, Rangueil University Hospital, Toulouse, France
| | - A Breda
- Uro-oncology and Kidney Transplant Unit, Department of Urology at "Fundació Puigvert" Hospital, Autonoma University of Barcelona, Barcelona, Spain
| | - R Boissier
- Department of Urology, La Conception University Hospital, Marseille, France
| | - T Prudhomme
- Department of Urology and Kidney Transplantation, Rangueil University Hospital, Toulouse, France.
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Fontanet S, Huguet J, Gaya JM, Territo A, Gallioli A, Aumatell J, Algaba F, Palou J, Breda A. Indications and histology of 489 orchiectomies analyzed by patient age. Actas Urol Esp 2023; 47:416-421. [PMID: 36427799 DOI: 10.1016/j.acuroe.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To evaluate the indications and histology of our series of orchiectomies, analysing the results by patient's age. METHODS We included the orchiectomies realized in our hospital between 2005 and 2020 in patients older than 18 years. We estimated demographic data, indications, histology and effectiveness of testicular ultrasound by three groups of age. RESULTS We included 489 orchiectomies, which 364 (74%) belonged to Group A (patients between 18-50 years), 59 (12%) to Group B (50-70 years) and 66 (14%) to Group C (older than 70 years). In Group A, 284 (78%) orchiectomies were indicated due to malignancy suspect. In 91.9% cases (261) malign neoplasm was confirmed at final histology and 253 (89%) were germinal cells. Testicular ultrasound had a positive predictive value (PPV) of 90% in this group. In Group B, 34 (57%) orchiectomies were indicated because of malignancy suspect. At final histologic analysis, 25/34 (73.5%) confirmed malign neoplasm. Ultrasound had a PPV of 68%. In Group C, orchiepididymitis was the main cause of testicular removal with 30 cases (45,5%). From the 20 cases (30.3%) with suspicion of malignancy, only 6 had confirmed malign histology. Testicular ultrasound PPV for malignancy was 31%. CONCLUSION In patients younger than 70 years the main orchiectomy's indication was suspect of malignancy and in older than 70, testicular inflammation. The germinal neoplasm was the predominant histology in younger than 70 years. In older than that, malignancy was infrequent. The positive predictive value of testicular ultrasound for malignancy decreased with patient's age. In patients older than 50 years proper image diagnosis to assess malignancy should be considered before orchiectomy is done.
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Affiliation(s)
- S Fontanet
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain.
| | - J Huguet
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - J M Gaya
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - A Territo
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - A Gallioli
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - J Aumatell
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - F Algaba
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Pathological Anatomy, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - J Palou
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - A Breda
- Fundació Puigvert (IUNA), Barcelona, Spain; Department of Urology, Fundació Puigvert, Autonomous University of Barcelona, Barcelona, Spain
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Pérez JH, Faba OR, Gaya Sopena JM, Palou Redorta J, Breda A. An aid to a better understanding of the definitions of BCG failure provided by the European Urology Association. Actas Urol Esp 2023; 47:395-397. [PMID: 36842705 DOI: 10.1016/j.acuroe.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 01/09/2023] [Indexed: 02/27/2023]
Affiliation(s)
| | | | | | | | - A Breda
- Fundació Puigvert, Barcelona, Spain
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Andras I, Pecoraro A, Piana A, Prudhomme T, Campi R, Hevia V, Boissier R, Crisan N, Breda A, Territo A. Aims and limits to compare open vs. robotic assisted kidney transplantation. Actas Urol Esp 2023; 47:193-194. [PMID: 36372359 DOI: 10.1016/j.acuroe.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 05/05/2023]
Affiliation(s)
- I Andras
- Urology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Urology Department, Clinical Municipal Hospital, Cluj-Napoca, Romania.
| | - A Pecoraro
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy
| | - A Piana
- Department of Urology, San Luigi Gonzaga Hospital, Univerity of Turin, Orbassano, Turin, Italy
| | - T Prudhomme
- Department of Urology and Kidney Transplantation, Toulouse University Hospital, Toulouse, France
| | - R Campi
- Unit of Urological Robotic Surgery and Renal Transplantation, University of Florence, Careggi Hospital, Florence, Italy; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - V Hevia
- Hospital Universitario Ramón y Cajal, Alcala University, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - R Boissier
- Service de Chirurgie Urologique et de Transplantation Renale, CHU Conception, Aix-Marseille Universite, Marseille, France
| | - N Crisan
- Urology Department, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania; Urology Department, Clinical Municipal Hospital, Cluj-Napoca, Romania
| | - A Breda
- Departement of Urology, Fundacio Puigvert, Autonomous University of Barcelona, Barcelona, Spain
| | - A Territo
- Departement of Urology, Fundacio Puigvert, Autonomous University of Barcelona, Barcelona, Spain
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Territo A, Fontanet S, Meneghetti I, Gallioli A, Sanguedolce F, Rodriguez-Faba Ó, Gaya J, Palou J, Huguet J, Breda A. Manejo del carcinoma in situ de tramo urinario superior diagnosticado por biopsia ureteroscópica: ¿es el bacilo de Calmette-Guérin una alternativa a la nefroureterectomía? Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2022.10.002] [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: 04/05/2023]
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Castellarnau S, Gaya JM, Espinosa J, Sierra P, Huguet J, Palou J, Hernando D, Sabaté S, Breda A. Clinical impact of the suspension of the ERAS protocol on patients undergoing radical cystectomy during the COVID-19 pandemic. Actas Urol Esp 2023:S2173-5786(23)00014-8. [PMID: 36842706 PMCID: PMC9957335 DOI: 10.1016/j.acuroe.2023.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/20/2023] [Indexed: 02/28/2023]
Abstract
INTRODUCTION During the beginning of the COVID-19 pandemic in our center, neither prehabilitation nor multimodal rehabilitation could be applied due to the excessive patient load on the health system and to reduce SARS-CoV-2 transmission. The objective of our study was to analyze the evolution, complications, and survival up to one year of patients who underwent radical cystectomy in our hospital from March 1st to May 31st, 2020 (period of the first wave COVID-19 pandemic in Spain). We also compared the results with cystectomized patients outside the pandemic period and with application of the ERAS (Enhanced Recovery After Surgery) protocol. MATERIAL AND METHODS Single-center, retrospective cohort study of patients scheduled for radical cystectomy from March 1st, 2020 to May 31st, 2020. They were matched with previously operated patients using a 1:2 propensity matching score. The matching variables were demographic data, preoperative and intraoperative clinical conditions. RESULTS A total of 23 radical cystectomies with urinary diversion were performed in the period described. In none of the cases the prehabilitation or the follow-up of our ERAS protocol could be applied, and this was the only difference we found between the 2 groups. Although the minimally invasive approach was more frequent in the pandemic group, the difference was not statistically significant. Three patients were diagnosed with COVID-19 during their admission, presenting severe respiratory complications and high in-hospital mortality. Apart from respiratory complications secondary to SARS-CoV-2, we also found statistically significant differences in other postoperative complications. The hospital stay increased by 3 days in the pandemic group. CONCLUSIONS Patients who underwent radical cystectomy at our center during the first wave of the COVID-19 pandemic had a higher number and severity of respiratory and non-respiratory complications. Discontinuation of the ERAS protocol was the main difference in treatment between groups.
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Affiliation(s)
- S Castellarnau
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain.
| | - J M Gaya
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Espinosa
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - P Sierra
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Huguet
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Palou
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - D Hernando
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S Sabaté
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Breda
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
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Castellarnau S, Gaya JM, Espinosa J, Sierra P, Huguet J, Palou J, Hernando D, Sabaté S, Breda A. [CLINICAL IMPACT OF THE SUSPENSION OF THE ERAS PROTOCOL ON PATIENTS UNDERGOING RADICAL CYSTECTOMY DURING THE COVID-19 PANDEMIC.]. Actas Urol Esp 2023; 47:S0210-4806(23)00012-8. [PMID: 36776227 PMCID: PMC9905094 DOI: 10.1016/j.acuro.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/20/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION During the beginning of the COVID-19 pandemic in our center, neither prehabilitation nor multimodal rehabilitation could be applied due to the excessive patient load on the health system and to reduce SARS-CoV-2 transmission. The objective of our study was to analyze the evolution, complications, and survival up to one year of patients who underwent radical cystectomy in our hospital from March 1st to May 31st, 2020 (period of the first wave COVID-19 pandemic in Spain). We also compared the results with cystectomized patients outside the pandemic period and with application of the ERAS (Enhanced Recovery After Surgery) protocol. MATERIAL AND METHODS Single-center, retrospective cohort study of patients scheduled for radical cystectomy from March 1st,2020 to May 31st, 2020. They were matched with previously operated patients using a 1:2 propensity matching score. The matching variables were demographic data, preoperative and intraoperative clinical conditions. RESULTS A total of 23 radical cystectomies with urinary diversion were performed in the period described. In none of the cases the prehabilitation or the follow-up of our ERAS protocol could be applied, and this was the only difference we found between the 2 groups. Although the minimally invasive approach was more frequent in the pandemic group, the difference was not statistically significant. Three patients were diagnosed with COVID-19 during their admission, presenting severe respiratory complications and high in-hospital mortality. Apart from respiratory complications secondary to SARS-CoV-2, we also found statistically significant differences in other postoperative complications. The hospital stay increased by 3 days in the pandemic group. CONCLUSIONS Patients who underwent radical cystectomy at our center during the first wave of the COVID-19 pandemic had a higher number and severity of respiratory and non-respiratory complications. Discontinuation of the ERAS protocol was the main difference in treatment between groups.
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Affiliation(s)
- S Castellarnau
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J M Gaya
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J Espinosa
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - P Sierra
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J Huguet
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - J Palou
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - D Hernando
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - S Sabaté
- Servicio de Anestesiología y Reanimación, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
| | - A Breda
- Servicio de Urología, Fundació Puigvert, Universitat Autònoma de Barcelona, Spain
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Fontanet S, Basile G, Baboudjian M, Gallioli A, Huguet J, Territo A, Parada R, Gavrilov P, Aumatell J, Sanz I, Bravo-Balado A, Verri P, Uleri A, Gaya JM, Palou J, Breda A. Robot-assisted vs. open radical cystectomy: systematic review and meta-analysis of randomized controlled trials. Actas Urol Esp 2023:S2173-5786(23)00005-7. [PMID: 36737037 DOI: 10.1016/j.acuroe.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Several randomized controlled trials (RCTs) have been launched in the last decade to examine the surgical safety and oncological efficacy of robot-assisted (RARC) vs open radical cystectomy (ORC) for patients with bladder cancer. The aim of the study was to perform a systematic review and meta-analysis of RCTs to compare the perioperative and oncological outcomes of RARC vs ORC. METHODS A literature search was conducted through July 2022 using PubMed/Medline, Embase, and Web of Science databases. Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines were followed to identify eligible studies. The outcomes were intraoperative, postoperative, and oncological outcomes of RARC vs ORC. RESULTS A total of eight RCTs comprising 1,024 patients met our inclusion criteria. RARC was associated with longer operative time (mean 92.34 min, 95% CI 83.83-100.84, p < 0.001) and lower blood transfusion rate (Odds ratio [OR] 0.43, 95% CI 0.30-0.61, p < 0.001). No differences emerged in terms of 90-day overall (p = 0.28) and major (p = 0.57) complications, length of stay (p = 0.18), bowel recovery (p = 0.67), health-related quality of life (p = 0.86), disease recurrence (p = 0.77) and progression (p = 0.49) between the two approaches. The main limitation is represented by the low number of patients included in half of RCTs included. CONCLUSIONS This study supports that RARC is not inferior to ORC in terms of surgical safety and oncological outcomes. The benefit of RARC in terms of lower blood transfusion rate need to be balanced with the cost related to the procedure.
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Affiliation(s)
- S Fontanet
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain.
| | - G Basile
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain; Department of Urology, IRCCS San Raffaele Hospital, Milan, Spain
| | - M Baboudjian
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain; Department of Urology, APHM, North Academic Hospital, Marseille, France; Department of Urology, APHM, La Conception Hospital, Marseille, France; Department of Urology, La Croix du Sud Hospital, Quint Fonsegrives, France
| | - A Gallioli
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - J Huguet
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - A Territo
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - R Parada
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - P Gavrilov
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - J Aumatell
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - I Sanz
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - A Bravo-Balado
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - P Verri
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - A Uleri
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - J M Gaya
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - J Palou
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
| | - A Breda
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
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Uleri A, Basile G, Gaya J, Territo A, Gallioli A, Verri P, Gavrilov P, Aumatell J, Fontanet S, Sanchez Molina R, Tedde A, Palou J, Breda A. Initial experience of robot-assisted partial nephrectomy with Hugo RAS™ system: Implications for surgical setting. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01426-4] [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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Basile G, Gallioli A, Verri P, Martini A, Territo A, Sanguedolce F, Fontanet S, Aumatell J, Uleri A, Rodriguez-Faba O, Palou J, Breda A. Follow-up intensity scheme for upper tract urothelial carcinoma after nephron-sparing surgery. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00966-1] [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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Uleri A, Baboudjian M, Gaya J, Oscar R, Rosales A, Gallioli A, Territo A, Robalino J, Casadevalls M, Farré A, Basile G, Verri P, Palou J, Breda A. A new machine learning model to predict Novel Trifecta achievement and validation of its prognostic significance in a large single centre series of minimally invasive partial nephrectomy. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00895-3] [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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Andras I, Pecoraro A, Piana A, Prudhomme T, Campi R, Hevia V, Boissier R, Crisan N, Breda A, Territo A. Objetivos y limitaciones al comparar el trasplante renal abierto frente al asistido por robot. Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2022.10.001] [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: 02/05/2023]
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Paciotti M, Diana P, Gaglioli A, De Groote R, Farinha R, Ficarra V, Gaston R, Gontero P, Hurle R, Martínez-Piñeiro L, Minervini A, Pansadoro V, Van Cleynenbreugel B, Wiklund P, Casale P, Lughezzani G, Mancon S, Uleri A, Mottrie A, Palou J, Gallagher A, Breda A, Buffi N. International experts consensus on performance metrics for a transurethral resection of bladder (TURB). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01094-1] [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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Diana P, Gallioli A, Territo A, Rodriguez-Faba Ó, Gaya J, Sanguedolce F, Huguet J, Parada R, Aumatell J, Bravo A, Algaba F, Palou J, Breda A. One year oncological outcome updated analysis of a single-center prospective, randomized, controlled, non-inferiority trial: En bloc vs. conventional transurethral resection of bladder tumor. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00332-9] [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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Gallioli A, Territo A, Basile G, Diana P, Verri P, Sanguedolce F, Gaya J, Gavrilov P, Uleri A, Fontanet S, Izquierdo P, Huguet J, Algaba F, Palou J, Breda A. The implementation of systematic biopsies in the endoscopic management of upper tract urothelial cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00551-1] [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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Dominguez Gutierrez A, Artiles Medina A, Subiela Henríquez J, Boissier R, Campi R, Prudhomme T, Pecoraro A, Breda A, Burgos Revilla F, Territo A, Hevia Palacios V. Kidney transplant outcomes in elderly population: A systematic review and meta-analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00459-1] [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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Pecoraro A, Li Marzi V, Sessa F, Boissier R, Hevia V, Prudhomme T, Andras I, Breda A, Serni S, Territo A, Campi R. Role of European urologists in kidney transplantation: An EAU-YAU kidney transplantation working group survey. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00450-5] [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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Amparore D, Piramide F, Piana A, Checcucci E, Basile G, Larcher A, Gallioli A, Territo A, Gaya J, Piazza P, Puliatti S, Grosso A, Mari A, Campi R, Serni S, Capitanio U, Montorsi F, Mottrie A, Fiori C, Minervini A, Breda A, Porpiglia F. 3D virtual models improve the accuracy of nephrometric scores in predicting surgical complexity during robotic partial nephrectomy: Results of a collaborative ERUS validation study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00888-6] [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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Amparore D, Pira F, Piana A, Checcucci E, Basile G, Larcher A, Gallioli A, Territo A, Gaya J, Piazza P, Puliatti S, Grosso A, Mari A, Campi R, Serni S, Capitanio U, Montorsi F, Mottrie A, Fiori C, Minervini A, Breda A, Porpiglia F. Functional outcomes prediction after robotic partial nephrectomy using PADUA score assessed with 3D virtual models: Preliminary results of a collaborative ERUS study. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00905-3] [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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Territo A, Verri P, Gallioli A, Uleri A, Basile G, Diana P, Gaya J, Sanguedolce F, Baboudjian M, Hernandez P, Farré A, Algaba F, Arce Y, Palou J, Breda A. Ex vivo confocal microscopy to diagnose upper tract urothelial carcinoma during URS. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01456-2] [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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Huguet Pérez J, Rodríguez Faba O, Gaya Sopena J, Palou Redorta J, Breda A. UNA AYUDA A LA MEJOR COMPRENSIÓN DE LAS DEFINICIONES DE FRACASO A LA BCG DADAS POR LA ASOCIACIÓN EUROPEA DE UROLOGIA. Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2023.01.003] [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: 02/11/2023]
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Baboudjian M, Breda A, Roumeguere T, Uleri A, Roche J, Touzani A, Lacetera V, Beauval J, Diamand R, Simone G, Windisch O, Benamran D, Fourcade A, Fiard G, Roumiguié M, Oderda M, Barret E, Fromont G, Dariane C, Gondran-Tellier B, Ruffion A, Van Den Bergh R, Peltier A, Ploussard G. Machine learning algorithm to define optimal candidates for active surveillance in intermediate-risk prostate cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00997-1] [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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Basile G, Verri P, Fontanet S, Gallioli A, Izquierdo P, Uleri A, Gaya J, Sanguedolce F, Palou J, Breda A. Assessing post-operative morbidity after retrograde/anterograde ureteroscopy for upper tract urinary cancer management using the EAU quality criteria for standardized reporting. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00954-5] [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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Grossmann N, Soria F, Juvet T, Potretzka A, Djaladat H, Kikuchi E, Mari A, Khene Z, Fujita K, Raman J, Breda A, Sfakianos J, Pfail J, Laukhtina E, Rajwa P, Pallauf M, Cacciamani G, Poyet C, Van Doeveren T, Boormans J, Antonelli A, Jamil M, Ploussard G, Shariat S, Pradere B. Comparing oncological and perioperative outcomes of open versus laparoscopic versus robotic radical nephroureterectomy for the treatment of upper tract urothelial carcinoma: A multicenter, multinational, propensity score-matched analysis. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00562-6] [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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Fontanet S, Basile G, Baboudjian M, Gallioli A, Huguet J, Territo A, Parada R, Gavrilov P, Aumatell J, Sanz I, Bravo-Balado A, Verri P, Uleri A, Gaya J, Palou J, Breda A. Cistectomía radical asistida por robot vs. cistectomía radical abierta: revisión sistemática de ensayos controlados aleatorizados. Actas Urol Esp 2023. [DOI: 10.1016/j.acuro.2022.11.003] [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: 01/29/2023]
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Territo A, Fontanet S, Meneghetti I, Gallioli A, Sanguedolce F, Rodriguez-Faba Ó, Gaya JM, Palou J, Huguet J, Breda A. Management of primary upper urinary tract carcinoma in situ diagnosed by ureteroscopic biopsy: Is bacillus Calmette-Guerin an alternative to nephroureterectomy? Actas Urol Esp 2022; 47:221-228. [PMID: 36379260 DOI: 10.1016/j.acuroe.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/19/2022] [Accepted: 10/20/2022] [Indexed: 11/14/2022]
Abstract
BACKGROUND Radical nephroureterectomy (RNU) represents the gold standard treatment for upper tract urothelial carcinoma (UTUC); however, attempts have been made to treat upper urinary tract CIS (UT-CIS) conservatively. The aim of this study was to compare the outcome of patients with primary UT-CIS treated in our center by means of RNU vs. bacillus Calmette-Guérin (BCG) instillations. METHODS This retrospective study included patients with diagnosis of primary UT-CIS between 1990 and 2018. All patients had histological confirmation of UT-CIS in the absence of other concomitant UTUC. Histological confirmation was obtained by ureteroscopy with multiple biopsies. Patients were treated with BCG instillations, RNU or distal ureterectomy. Clinicopathological features and outcomes were compared between RNU and BCG groups. RESULTS A total of 28 patients and 29 renal units (RUs) were included. Sixteen (57.1%) patients (17 RUs) received BCG. BCG was administered via nephrostomy tube in 4 patients, with a single-J ureteral stent in 5, and using a Double-J stent in 7. Complete response and persistence or recurrence were detected in ten (58.8%) and seven (41.2%) RUs treated with BCG, respectively. Eight (27.6%) RUs underwent RNU, and 4 (13.8%) Rus distal ureterectomy. No differences were found in recurrence-free survival (p=0.841) and cancer-specific survival (p=0.77) between the RNU and BCG groups. CONCLUSIONS Although RNU remains the gold standard treatment for UT-CIS, our results confirm that BCG instillations are also effective. Histological confirmation of UT-CIS is mandatory before any treatment.
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Affiliation(s)
- A Territo
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - S Fontanet
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain.
| | - I Meneghetti
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Gallioli
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - F Sanguedolce
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - Ó Rodriguez-Faba
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J M Gaya
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Palou
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Huguet
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Breda
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
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Sanguedolce F, Tedde A, Tedde M, Hernandez J, Granados L, Subiela J, Robalino J, Suquilanda E, Palou J, Breda A. Defining the role of preoperative multiparametric Magnetic Resonance Imaging (mpMRI) to predict extracapsular extension in radical prostatectomy specimen. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02352-7] [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: 11/11/2022] Open
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Emiliani E, Territo A, Calderón Cortez J, Meneghetti I, Subiela J, Basile G, Angerri O, Palou J J, Breda A. Evaluación de la dinámica de la temperatura intrarrenal con el uso de láseres holmio y tulio YAG en un modelo ex vivo de riñón porcino. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2022.05.006] [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: 11/07/2022]
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Gaya J, Territo A, Woldu S, Schwartzmann I, Verri P, González-Pérez L, Cózar J, Miñana B, Medina R, de la Rosa-Kehrmann F, Lozano-Palacio F, Ribal M, Hernández C, Castiñeiras J, Requena M, Moreno J, Caraballido J, Baena V, Breda A, Palou Redorta J. Diagnóstico incidental del cáncer de vejiga en España. Estudio observacional a nivel nacional. Actas Urol Esp 2022. [DOI: 10.1016/j.acuro.2022.09.002] [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: 11/06/2022]
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Uleri A, Verri P, Gallioli A, Territo A, Baboudjian M, Bravo A, Izquierdo P, Gaya J, Rodriguez-Faba Ó, Breda A, Palou J. Robotic-assisted radical cystectomy with Hugo RAS: The first European case. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02253-4] [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: 11/06/2022] Open
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Diana P, Gaya J, Rodriguez-Faba Ó, Gallioli A, Breda A, Palou J. Enucleation of Complex Renal Masses: Tips and tricks. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02227-3] [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: 11/06/2022] Open
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Diana P, Territo A, Gaya J, Gavrilov P, Verri P, Bravo-Balando A, Fontanet S, Palou J, Breda A. Robotic-assisted partial nephrectomy with the HUGO RAS system. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02237-6] [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: 11/07/2022] Open
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Gallioli A, Diana P, Fontana M, Territo A, Piana A, Verri P, Algaba F, Rodriguez-Faba Ó, Rosales A, Gaya J, Sanguedolce F, Palou J, Breda A. En-bloc versus conventional transurethral resection of bladder tumors: single-center prospective randomized trial. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)01223-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: 11/05/2022] Open
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Verri P, Uleri A, Diana P, Baboudjian M, Gaya J, Rodriguez-Faba O, Gallioli A, Huguet J, Bravo A, Aumatell J, Breda A, Palou J. Challenging robotic-assisted radical cystectomy in patient with history of radical prostatectomy and radiotherapy. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)02225-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: 11/07/2022] Open
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Verri P, Baboudjian M, Diana P, Gallioli A, Territo A, Gaya J, Huguet J, Rodriguez-Faba O, Palou J, Breda A. Reduced- vs full-dose BCG in bladder cancer: a systematic review and meta-analysis. Actas Urológicas Españolas (English Edition) 2022; 47:4-14. [PMID: 37078844 DOI: 10.1016/j.acuroe.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 06/26/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To assess the oncologic outcomes and the safety profile of a reduced-dose versus full-dose BCG regimen in patients with non-muscle-invasive bladder cancer (NMIBC). MATERIAL AND METHODS We performed a systematic review according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The PubMed, Embase, and Web of Science databases were searched in January 2022 for studies that analyzed oncological outcomes and compared between reduced- and full-dose BCG regimens. RESULTS Seventeen studies including 3757 patients met our inclusion criteria. Patients who received reduced-dose BCG had significantly higher recurrence rates (OR 1.19; 95%CI, 1.03-1.36; p = 0.02). The risks of progression to muscle-invasive BC (OR 1.04; 95%CI, 0.83-1.32; p = 0.71), metastasis (OR 0.82; 95%CI, 0.55-1.22; p = 0.32), death from BC (OR 0.80; 95%CI, 0.57-1.14; p = 0.22), and all-cause death (OR 0.82; 95%CI, 0.53-1.27; p = 0.37) were not statistically different. When restricting the analyses to randomized controlled trials, we found similar results. In subgroup analysis, reduced dose was associated with a higher rate of BC recurrence in studies that used only an induction regimen (OR 1.70; 95%CI, 1.19-2.42; p = 0.004), but not when a maintenance regimen was used (OR 1.07; 95%CI, 0.96-1.29; p = 0.17). Regarding side effects, the reduced-dose BCG regimen was associated with fewer episodes of fever (p = 0.003), and therapy discontinuation (p = 0.03). CONCLUSION This review found no association between BCG dose and BC progression, metastasis, and mortality. There was an association between reduced dose and BC recurrence, which was no longer significant when a maintenance regimen was used. In times of BCG shortage, reduced-dose regimens could be offered to BC patients.
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Emiliani E, Territo A, Calderón Cortez J, Meneghetti I, Subiela J, Basile G, Angerri O, Palou J J, Breda A. Assessment of intrarenal temperature dynamics when using holmium and thulium: YAG lasers in an ex vivo porcine kidney model. Actas Urológicas Españolas (English Edition) 2022; 47:159-164. [PMID: 37013354 DOI: 10.1016/j.acuroe.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM To measure the temperature dynamics at the renal surface and within the urinary tract when using Ho:YAG and Tm:YAG lasers for tissue ablation. MATERIALS AND METHODS Porcine kidneys were used. Both types of lasers with different configurations and fiber sizes were used through a flexible ureteroscope. The temperature at the renal surface was recorded using a thermal camera while the intrarenal temperature was measured using two thermal probes, the first one at the ureteropelvic junction and the second one at the calyx used for lasering. Temperature was determined at 0.5-1-3-5 and 10 min. RESULTS Recordings at the ureteropelvic junction and calyx revealed significant increases when using Tm:YAG with the 273 μm (10 W to 50 W) (p ≤ 0.02) and 550 μm (10 W) fiber (p = 0.04). With Ho:YAG there was a significant increase when using 273 μm (at 10 W and 20 W) (p ≤ 0.03) and 365 μm (10 W) fibers (p = 0.04). Regarding fiber size there was a significant difference when using Tm:YAG (at 20 W and 40 W) (p < 0.05). The thermal camera recorded a mean increase of 8 °C in the UPJ while the remaining areas of the kidney did not undergo significant changes. CONCLUSIONS Temperature changes were greater when using the Ho:YAG laser with respect to Tm:YAG at similar power settings for tissue ablation. The greatest temperature increase was recorded at the UPJ from where the heat dissipated throughout the kidney.
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Guven S, Colecchia M, Oltulu P, Bonfante G, Enikeev D, Esen H, Herrmann T, Lusuardi L, Micali S, Somani B, Skolarikos A, Breda A, Liatsikos E, Redorta J, Gozen A. How do endoscopic bladder tumor resection techniques affect pathology practice? EAU Section of Uro-Technology (ESUT) and Uropathology (ESUP) survey. EUR UROL SUPPL 2022. [DOI: 10.1016/s2666-1683(22)00206-3] [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: 11/30/2022] Open
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Calderón Cortez JF, Territo A, Fontana M, Gaya JM, Sanguedolce F, Palou J, Huguet J, Breda A. Primary urethral carcinoma: Results from a single center experience. Actas Urol Esp 2022; 46:70-77. [PMID: 35120853 DOI: 10.1016/j.acuroe.2020.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 10/26/2020] [Indexed: 06/14/2023]
Abstract
INTRODUCTION AND AIM OF THE STUDY Primary urethral carcinoma (PUC) is a rare neoplastic disease arising in the urethra, without any evidence of a previous or synchronous carcinoma of the entire urinary tract. Since rare diseases are often incorrectly diagnosed and managed, the aim of this study was to analyze the experience of a single urology center in the treatment of PUC, focusing on neoplasms arising from the male anterior urethra. MATERIALS AND METHODS Medical records of patients with neoplasms at the level of the penile and bulbar urethra who presented at our tertiary referral center between January 1988 and December 2018 were retrospectively reviewed. Patients with carcinoma of the prostatic urethra were excluded. The diagnosis was obtained with the aid of urethroscopy and lesion biopsy. Local staging was performed by means of contrast-enhanced MRI in selected patients. Staging was achieved by clinical examination, ultrasonography, and CT scan. Radical surgery (radical cystectomy + total penectomy + bilateral inguinal lymphadenectomy) was proposed to patients with ≥T2 tumors or cN+ with a good performance status, proximal tumor and without severe comorbidities. In case of nodal involvement, neoadjuvant chemotherapy was additionally offered. Patients with localized disease (<T2) and/or more distal tumors underwent urethrectomy or partial penectomy. Kaplan-Meier curves were evaluated for analysis of overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS). RESULTS A total of 13 male patients with anterior PUC were studied retrospectively. Total penectomy was performed in 7 cases, while partial urethrectomy was performed in 5 cases, and partial penectomy in 1 case. Of the 7 patients who underwent total penectomy, 5 underwent radical cystectomy with bilateral inguinal lymphadenectomy. Three patients were treated with neoadjuvant systemic chemotherapy, of which 2 were cT3N+ and 1 was cT3N0. The predominant histologic subtype was squamous cell carcinoma (SCC), found in 7 patients (53.8%), while urothelial carcinoma (UC) was present in 5 patients (38.5%) and a malignant fibro-histiocytoma in 1 case. Most patients were diagnosed at advanced stages of the disease, with T2 tumors in 15.4% and T3 tumors in 46.2% of the cases. Median follow-up was 24 months (range 1-294). After surgical treatment, 8 patients (61.5%) presented disease recurrence after a median of 6.3 months, with a 5-year RFS of 58% ± 14%. The 5-year OS rate was 50% ± 14% while the 5-year CSS rate was 66% ± 13%. CONCLUSION Given its rarity, urethral carcinoma should be treated in a referral center. Treatment options include a radical approach or penile-preserving surgery (urethrectomy or partial penectomy) in cases of localized disease. Due to the high recurrence rate, strict follow-up is mandatory.
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Affiliation(s)
- J F Calderón Cortez
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Territo
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain.
| | - M Fontana
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J M Gaya
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - F Sanguedolce
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Palou
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - J Huguet
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
| | - A Breda
- Departamento de Urología, Fundació Puigvert, Universidad Autónoma de Barcelona, Barcelona, Spain
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Piana A, Gallioli A, Diana P, Territo A, Gaya J, Gavrilov P, Rodriguez Faba Ó, Huguet J, Guirado L, Facundo C, Campi R, Bellin A, Amparore D, Serni S, Palou J, Porpiglia F, Breda A. 3D Augmented reality-guided robotic-assisted kidney transplantation: Revealing the concealed. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01361-6] [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: 11/04/2022]
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Katayama S, Pradere B, Grossmann N, Potretzke A, Boorjian S, Daneshmand S, Djaladat H, Sfakianos J, Mari A, Khene Z, D’Andrea D, Kikuchi E, Fujita K, Heindenreich A, Raman J, Roumiguié M, Abdollah F, Marcus J, Breda A, Fontana M, Rouprêt M, Araki M, Nasu Y, Shariat S. Clinical significance of tumor location for ureteroscopic tumor grading in upper tract urothelial carcinoma. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00383-9] [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: 11/04/2022]
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Marra G, Agnello M, Giordano A, Peretti F, Soria F, Oderda M, Dariane C, Timsit M, Branchereau J, Hedli O, Mesnard B, Tilki D, Olsburgh J, Kulkarni M, Kasivisvanathan V, Lebacle C, Breda A, Biancone L, Gontero P. Robotic radical prostatectomy for prostate cancer in renal transplant recipients: Results from a multicenter series. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01312-4] [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: 11/04/2022]
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Crocerossa F, Autorino R, Derweesh I, Carbonara U, Cantiello F, Damiano R, Rubio-Briones J, Roupret M, Breda A, Volpe A, Mir M. Management of renal cell carcinoma in transplant kidney: An individual patient data meta-analysis and evidence-based guide. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00312-8] [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: 11/28/2022]
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Brassetti A, Cozzi G, Gavrilov P, Chavarriaga Soto J, Bove A, Anceschi U, Ferriero M, Mastroianni R, Misuraca L, Tuderti G, Musi G, De Cobelli O, Breda A, Gaya Sopena J, Camacho D, Varela R, Simone G. Inguinal lymph node dissection for penile cancer: Results of a minimally invasive approach from a multicenter database. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00766-7] [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: 11/25/2022]
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Campi R, Pecoraro A, Li Marzi V, Tuccio A, Barzaghi P, Corti F, Rivetti A, Nicoletti R, Gacci M, Morselli S, Sebastianelli A, Sessa F, Spatafora P, Giancane S, Peris A, Cirami C, Breda A, Vignolini G, Serni S. Robotic versus open kidney transplantation from deceased donors: The first prospective observational study. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01171-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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Boissier R, Hidalgo R, Rodríguez Faba O, Territo A, Subiela JD, Huguet J, Sánchez-Puy A, Gallioli A, Vanacore D, Mercade A, Martinez C, Palou J, Guirado L, Breda A. History of urological malignancies before kidney transplantation, oncological outcome on the long term. Actas Urol Esp 2021; 45:623-634. [PMID: 34764048 DOI: 10.1016/j.acuroe.2020.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/05/2020] [Indexed: 10/19/2022]
Abstract
INTRODUCTION We aimed to report the oncological outcomes of ESRD patients with histories of urological malignancies who were subsequently submitted to kidney transplantation (KT). MATERIAL AND METHOD Retrospective study lead in the Puigvert Foundation (Barcelona) registry of 1,200 KT performed from 1988 to 2018. Eighty-five urological malignancies that were treated before KT in 81 patients were identified: 15 (18%) prostate cancers, 49 (58%) RCC, 19 (22%) urothelial carcinomas and 2 (2%) testicular cancers. Baseline characteristics, cancer staging, treatment and follow-up were registered as well as the chronology of the start of dialysis, inscription on the waiting list and kidney transplantation. Endpoints included were cancer recurrence, metastatic progression, cancer-specific death and overall survival. RESULTS In a median follow-up of 13.1 years (2.2-32), 16/85 (19%) cancer recurrences were reported, with 3 (4%) who progressed to metastasis and died of cancer. Median overall survival after cancer treatment was 25.3 years and cancer-specific survival was 95% at 25 years. Median time from cancer treatment to kidney transplantation was 4.8 years: 3.7 years in prostate cancer, 3.9 years in RCC and 8.8 years in bladder cancer. The median time from start of dialysis to kidney transplantation was 1.8 years in patients with histories of urological malignancy versus 0.5 year in the total cohort of 1,200 renal transplanted over the same period. CONCLUSIONS Well-selected patients with histories of urological malignancies greatly benefit from kidney transplantation with infrequent and late cancer recurrence. Waiting time could be optimized in low-risk prostate cancer and RCC, but more robust data are needed.
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Affiliation(s)
- R Boissier
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain.
| | - R Hidalgo
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - O Rodríguez Faba
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - A Territo
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - J D Subiela
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - J Huguet
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - A Sánchez-Puy
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - A Gallioli
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - D Vanacore
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - A Mercade
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - C Martinez
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - J Palou
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - L Guirado
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
| | - A Breda
- Departmento de Urología, Fundaciò Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain; Servicio de Nefrología, Fundació Puigvert, Instituto de Investigaciones Biomédicas Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, REDinREN, Instituto de Investigación Carlos III, Spain
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