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Prognostic role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with non-metastatic and metastatic prostate cancer:A meta-analysis and systematic review

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Asian Journal of Urology 2024年第2期11卷 191-207页

作者： Stefano Salciccia Marco Frisenda Giulio Bevilacqua Pietro Viscuso Paolo Casale Ettore De Berardinis Giovanni Battista Di Pierro Susanna Cattarino Gloria Giorgino Davide Rosati Francesco Del Giudice alessandro sciarra Gianna Mariotti alessandro Gentilucci Department of Urology Sapienza Rome UniversityPoliclinico Umberto I00161 RomeItaly Department of Urology Humanitas20089 RozzanoMIItaly

Objective: To analyze data available in the literature regarding a possible prognostic value of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in prostate cancer (PCa) patients stratified in non-metastatic and metastatic diseases.Methods: A literature search process was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. In our meta-analysis, the pooled event rate estimated and the pooled hazard ratio were calculated using a random effect model.Results: Forty-two articles were selected for our analysis. The pooled risk difference for non-organ confined PCa between high and low NLR cases was 0.06 (95% confidence interval [CI]: −0.03-0.15) and between high and low PLR cases increased to 0.30 (95% CI: 0.16-0.43). In non-metastatic PCa cases, the pooled hazard ratio for overall mortality between high and low NLR was 1.33 (95% CI: 0.78-1.88) and between high and low PLR was 1.47 (95% CI: 0.91-2.03), whereas in metastatic PCa cases, between high and low NLR was 1.79 (95% CI: 1.44-2.13) and between high and low PLR was 1.05 (95% CI: 0.87-1.24).Conclusion: The prognostic values of NLR and PLR in terms of PCa characteristics and responses after treatment show a high level of heterogeneity of results among studies. These two ratios can represent the inflammatory and immunity status of the patient related to several conditions. A higher predictive value is related to a high NLR in terms of risk for overall mortality in metastatic PCa cases under systemic treatments.

关键词： Prostatic neoplasm Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyteratio Meta-analysis Radical prostatectomy Metastatic

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A systematic review of robot-assisted partial nephrectomy outcomes for advanced indications:Large tumors(cT2-T3),solitary kidney,completely endophytic,hilar,recurrent,and multiple renal tumors

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Asian Journal of Urology 2023年第4期10卷 390-406页

作者： Savio Domenico Pandolfo Clara Cerrato Zhenjie Wu Antonio Franco Francesco Del Giudice alessandro sciarra Paolo Verze Giuseppe Lucarelli Ciro Imbimbo Sisto Perdonà Edward E.Cherullo Francesco Porpiglia Ithaar H.Derweesh Riccardo Autorino Department of Urology Rush University Medical CenterChicagoILUSA Department of Neurosciences Reproductive Sciences and Odontostomatology“Federico II”UniversityNaplesItaly Department of Urology University of VeronaVeronaItaly Department of Urology Changhai HospitalNaval Medical UniversityShanghaiChina European Association of Urology(EAU)Young Academic Urologists(YAU)Renal Cancer Working Group Arnhemthe Netherlands Department of Urology Sant’Andrea HospitalLa Sapienza UniversityRomeItaly Department of Maternal-Infant and Urologic Sciences La Sapienza UniversityPoliclinico Umberto I HospitalRomeItaly Department of Medicine and Surgery Scuola Medica SalernitanaUniversity of SalernoFiscianoItaly Department of Emergency and Organ Transplantation-Urology Andrology and Kidney Transplantation UnitUniversity of BariBariItaly Department Uro-Gynecology IRCCS G.Pascale FoundationNaplesItaly Department of Urology San Luigi Gonzaga HospitalUniversity of TurinOrbassanoItaly Department of Urology University of California San DiegoLa JollaCAUSA

Objective:Robot-assisted partial nephrectomy(RAPN)has become widely used for treatment of renal cell carcinoma and it is expanding in the field of complex renal masses.The aim of this systematic review was to analyze outcomes of RAPN for completely endophytic renal masses,large tumors(cT2-T3),renal cell carcinoma in solitary kidney,recurrent tumors,completely endophytic and hilar masses,and simultaneous and multiple tumors.Methods:A comprehensive search in the PubMed,Scopus,Web of Science,and Cochrane Central Register of Controlled Trials databases was performed in December 2022 for English language papers.The primary endpoint was to evaluate the role of RAPN in the setting of each category of complex renal masses considered.The secondary endpoint was to evaluate the surgical and functional outcomes.Results:After screening 1250 records,43 full-text manuscripts were selected,comprising over 8500 patients.Twelve and thirteen studies reported data for endophytic and hilar renal masses,respectively.Five and three studies reported outcomes for cT2-T3 and solitary kidney patients,respectively.Four studies focused on redo-RAPN for recurrent tumors.Two studies investigated simultaneous bilateral renal masses and five reports focused on multiple tumor excision in ipsilateral kidney.Conclusion:Over the past decade,evidence supporting the use of RAPN for the most challenging nephron-sparing surgery indications has continuously grown.Although limitations remain including study design and lack of detailed long-term functional and oncological outcomes,the adoption of RAPN for the included advanced indications is associated with favorable surgical outcomes with good preservation of renal function without compromising the oncological result.Certainly,a higher likelihood of complication might be expected when facing extremely challenging cases.However,none of these indications should be considered per se an exclusion criterion for performing RAPN.Ultimately,a risk-adapted approach should be employed.

关键词： Robot-assisted partial nephrectomy Complex renal mass Solitary kidney Larger tumors(cT2-T3) Endophytic and hilar mass Recurrent tumor Simultaneous and multiple tumor

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A systematic review and meta-analysis of clinical trials implementing aromatase inhibitors to treat male infertility

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Asian Journal of Andrology 2020年第4期22卷 360-367页

作者： Francesco Del Giudice Gian Maria Busetto Ettore De Berardinis Isabella Sperduti Matteo Ferro Martina Maggi Martin S Gross alessandro sciarra Michael L Eisenberg Department of Urology Sapienza Rome UniversityPoliclinico Umberto IRome 00161Italy Biostatistical Unit IRCCSRegina Elena National Cancer InstituteRome 00128Italy Division of Urology European Institute of OncologyMilan 20141Italy Section of Urology Dartmouth-Hitchcock Medical CenterLebanonNH 03766USA Department of Urology Stanford UniversitySchool of MedicineStanfordCA 94305USA

Aromatase activity has commonly been associated with male infertility characterized by testicular dysfunction with low serum testosterone and/or testosterone to estradiol ratio.In this subset of patients,and particularly in those with hypogonadism,elevated levels of circulating estradiol may establish a negative feedback on the hypothalamic–pituitary–testicular axis by suppressing follicle-stimulating hormone(FSH)and luteinizing hormone(LH)production and impaired spermatogenesis.Hormonal manipulation via different agents such as selective estrogen modulators or aromatase inhibitors to increase endogenous testosterone production and improve spermatogenesis in the setting of infertility is an off-label option for treatment.We carried out a systematic review and meta-analysis of the literature of the past 30 years in order to evaluate the benefits of the use of aromatase inhibitors in the medical management of infertile/hypoandrogenic males.Overall,eight original articles were included and critically evaluated.Either steroidal(Testolactone)or nonsteroidal(Anastrozole and Letrozole)aromatase inhibitors were found to statistically improve all the evaluated hormonal and seminal outcomes with a safe tolerability profile.While the evidence is promising,future prospective randomized placebo-controlled multicenter trials are necessary to better define the efficacy of these medications.

关键词： aromatase inhibitor hypogonadism male infertility meta-analysis systematic review

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Comparison of partners-heart failure algorithm vs care alert in remote heart failure management

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World Journal of Cardiology 2015年第12期7卷 922-930页

作者： Leonardo Calo’ Annamaria Martino Claudia Tota alessandro Fagagnini Renzo Iulianella Marco Rebecchi Luigi sciarra Giuseppe Giunta Maria Grazia Romano Roberto Colaceci Antonio Ciccaglioni Fabrizio Ammirati Ermenegildo de Ruvo Division of Cardiology Policlinico Casilino Cardiovascular RespiratoryNephrologic and Geriatrics Sciences DepartmentUmberto I HospitalSapienza University of Rome Department of Cardiology G.B. Grassi Hospital

AIM: To compare the utility of the partners-heart failure(HF) algorithm with the care alert strategy for remote monitoring,in guiding clinical actions oriented to treat impending HF.METHODS: Consecutive cardiac resynchronizationdefibrillator recipients were followed with biweekly automatic transmissions. After every transmission,patients received a phone contact in order to check their health status,eventually followed by clinical actions,classified as "no-action","non-active" and "active". Active clinical actions were oriented to treat impending HF. The sensitivity,specificity,positive and negative predictive values and diagnostic accuracy of the partners-HF algorithm vs care alert in determining active clinical actions oriented to treat pre-HF status and to prevent an acute decompensation,were also calculated.RESULTS: The study population included 70 patients with moderate to advanced systolic HF and QRS duration longer than 120 ms. During a mean follow-up of 8 ± 2 mo,665 transmissions were collected. No deaths or HF hospitalizations occurred. The sensitivity and specificity of the partners-HF algorithm for active clinical actions oriented to treat impending HF were 96.9%(95%CI: 0.96-0.98) and 92.5%(95%CI: 0.90-0.94) respectively. The positive and negative predictive values were 84.6%(95%CI: 0.82-0.87) and 98.6%(95%CI: 0.98-0.99) respectively. The partners-HF algorithm had an accuracy of 93.8%(95%CI: 0.92-0.96) in determining active clinical actions. With regard to active clinical actions,care alert had a sensitivity and specificity of 11.05%(95%CI: 0.09-0.13) and 93.6% respectively(95%CI: 0.92-0.95). The positive predictive value was 42.3%(95%CI: 0.38-0.46); the negative predictive value was 71.1%(95%CI: 0.68-0.74). Care alert had an accuracy of 68.9%(95%CI: 0.65-0.72) in determining active clinical actions.CONCLUSION: The partners-HF algorithm proved higher accuracy and sensitivity than care alert in determining active clinical actions oriented to treat impending HF. Future studies in larger populations shoul

关键词： Heart failure Cardiac resynchronization therapy Defibrillators Remote monitoring

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