Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia
-
Arch Ital Urol Androl · Dec 2017
Can re-cTURBT be useful in pT1HG disease as a risk indicator of recurrence and progression? A single centre experience.
Understaging after initial transurethral resection is common in patients with high-risk non muscle infiltrating bladder cancer (NMIBC) and can delay accurate diagnosis and definitive treatment. The rate of upstaging from T1 to T2 disease after repeated transurethral resection ranges from 0 to 28%, although the rate of upstaging may be even higher up to 49% when muscularis propria is absent in the first specimen. A restaging classic transurethral resection of bladder tumour (re-cTURBT) is the better predictor of early stage progression. According to some reports, the rate of positivity for tumor in re-cTURBT performed within eight weeks after initial cTURBT was as high as 18-77%, and in about 40% of the patients a change in tumor stage was reported. We aimed to investigate, in high risk group, the presence of residual tumor following white light classical transurethral resection of bladder tumor (WLre-cTURBT) and the different recurrence and progression rate between patients with persistent or negative (pT0) oncological disease after WLre-cTURBT. ⋯ Following WLre-cTURBt in HG-NMIBC patients we identified in 15% of cases a persistent disease with a 4.3% of MIBC. In the high risk persistent bladder neoplasms group we observed recurrent and progression rate higher than in T0 bladder tumours group (Δ = + 17.3% and = Δ + 62.5%, p < 0.05.
-
Arch Ital Urol Androl · Oct 2017
Comment LetterThe eternal enigma in prostatic biopsy access route.
Dear Editors,We read with interest the article by Di Franco and co-workers (1). The introduction of prostatic magnetic resonance and the relative fusion-biopsy have not yet allowed the expected improvements in prostate biopsy. To our knowledge, there are no works that demonstrate the superiority of fusion techniques on the remaining ultrasound guided prostate biopsies that are still the widely used in the diagnosis of prostate cancer. ⋯ Trasrectal versus transperineal saturation re biopsy of the prostate: is there a difference in cancer detection rate? Urology 2011; 77:9215) Novella G, Ficarra V, Galfano A, et al. Pain assessment after original transperineal prostate biopsy using a coaxial needle. Urology. 2003; 62 : 689-92.
-
Arch Ital Urol Androl · Jun 2017
Review Case ReportsMetastasis of renal cell carcinoma to the thyroid gland 9 years after nephrectomy: A case report and literature review.
We report a case presenting with thyroid and lung metastases of renal cell carcinoma that was treated with molecular targeted therapy followed metastasectomy. A 52-year-old female underwent radical nephrectomy of right renal cell carcinoma in 2007. The patient presented 9 years after nephrectomy at the age of 61 years with sudden loss of vision on the left side and a mass on the neck. ⋯ The patient is currently receiving a single dose of pazopanib per day (400 mg/day) and the general condition is good. Thyroid metastasis should be considered in patients with a thyroid nodule and positive history for renal cell carcinoma. Successful results can be obtained with metastasectomy and systemic targeted therapy.
-
Arch Ital Urol Androl · Mar 2017
Comparative StudyA retrospective comparison between transrectal and transperineal prostate biopsy in the detection of prostate cancer.
The aim of this study was to analyze the differences between TRUSguided transrectal prostate biopsy (TR) and transperineal prostate biopsy (TP) in the diagnosis of prostate cancer. The two biopsy methods were evaluated in terms of diagnostic sensitivity and of early and late complications. ⋯ No statistically significant differences in sensitivity were observed between TP and TR biopsy, but TP biopsy detected more cancers at first time biopsy. Complications rate was lower in the TP group. Therefore, we conclude that the Urologist has the final choice in deciding the most appropriate biopsy technique, considering sensitivity and complications.
-
Arch Ital Urol Androl · Dec 2016
Comparative StudyDetection rate for significant cancer at confirmatory biopsy in men enrolled in Active Surveillance protocol: 20 cores vs 30 cores vs MRI/TRUS fusion prostate biopsy.
The detection rate for significant prostate cancer of extended vs saturation vs mMRI/TRUS fusion biopsy was prospectively evaluated in men enrolled in active surveillance (AS) protocol. Mterials and methods: From May 2013 to September 2016 75 men aged 66 years (median) with very low risk PCa were enrolled in an AS protocol and elegible criteria were: life expectancy greater than 10 years, cT1C, PSA below 10 ng/ml, PSA density < 0.20, 2 < unilateral positive biopsy cores, Gleason score (GS) equal to 6, greatest percentage of cancer (GPC) in a core < 50%. All patients underwent 3.0 Tesla pelvic mpMRI before confirmatory transperineal extended (20 cores) or saturation biopsy (SPBx; 30 cores) combined with mpMRI/TRUS fusion targeted biopsy (4 cores) of suspicious lesions (PI-RADS 3-5). ⋯ Although mpMRI improve the diagnosis of clinically significant PCa, SPBx is provided of the best detection rate for PCa in men enrolled in AS protocols who underwent confirmatory biopsy.