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Asian Journal of Andrology 2024年第6期26卷 557-558页

作者： antonio benito porcaro Department of Urology University of VeronaAzienda Ospedaliera Universitaria IntegrataVerona 37124Italy

This opinion focuses on the management of low-and intermediate-risk prostate cancer(PCa)groups,emphasizing the need for additional prognostic factors beyond existing risk *** biology and multiparametric magnetic resonance imaging(mpMRI)applications are still facing challenges or limitations,whereas nomograms,particularly those predicting pelvic lymph node invasion and therefore associating with aggressive biology,could potentially have a prognostic impact on disease *** also discuss the impact of the prostate microenvironment,endocrine dependency,and variations in testosterone levels on cancer biology,introducing new concepts such as endogenous testosterone density.

关键词： invasion endogenous looking

The role of endogenous testosterone in relationship with low-and intermediate-risk prostate cancer:a systematic review

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Asian Journal of Andrology 2024年第6期26卷 569-574页

作者： antonio benito porcaro Emanuele Serafin Davide Brusa Sonia Costantino Claudio Brancelli Maria Angela Cerruto Alessandro Antonelli Department of Urology University of VeronaIntegrate University HospitalVerona 37126Italy

An enduring debate in research revolves around the association between elevated endogenous testosterone levels and prostate cancer. This systematic review is intended to assess the present understanding of the role of endogenous testosterone in the diagnosis and treatment of low- and intermediate-risk prostate cancer. Our search strategy was the following: (endogenous testosterone) AND (((low risk) OR (intermediate risk)) AND ((diagnosis) OR (treatment))) AND (prostate cancer);that was applied to PubMed, Web of Science, and Scopus databases to identify pertinent articles. Two investigators performed an independent selection following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The preliminary investigation detected 105 records, and 81 records remained after eliminating duplicates. Following the review of titles and abstracts, 71 articles were excluded. A comprehensive examination of the full text was conducted for 10 articles, excluding 3 of them. After revising the references of eligible articles, other 3 articles were included. We finally identified 10 suitable studies, including three main topics: (1) association between endogenous testosterone and European Association of Urology (EAU) risk classes;(2) association between endogenous testosterone density and the tumor load;and (3) association of endogenous testosterone with tumor upgrading and tumor upstaging. Actual literature about the impact of endogenous testosterone on low- and intermediate-risk prostate cancer is not numerous, but appears to be still conflicting. More investigations are needed to increase the consistency of the literature’s results.

关键词： endogenous testosterone intermediate-risk prostate cancer low-risk prostate cancer

Prostate chronic inflammation type Ⅳ and prostate cancer risk in patients undergoing first biopsy set:Results of a large cohort study

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Asian Journal of Urology 2015年第4期2卷 224-232页

作者： antonio benito porcaro Giovanni Novella Matteo Balzarro Guido Martignoni Matteo Brunelli Giovanni Cacciamani Maria ACerruto Walter Artibani Urologic Clinic University HospitalOspedale PoliclinicoAzienda Ospedaliera Universitaria IntegrataVeronaItaly Department of Pathology University HospitalOspedale PoliclinicoAzienda Ospedaliera Universitaria IntegrataVeronaItaly

Objective:In prostate specimens,chronic inflammatory infiltrate(CII)type Ⅳ has been detected,but its association with prostate cancer(PCa)is *** aim of the present study is to investigate on associations of CII with PCa detection in patients undergoing prostate first biopsy ***:Ultrasound transrectal-guided biopsies by the transperineal approach were retrospectively evaluated in 441 consecutive *** study excluded patients who were in active surveillance,prostate specific antigen(PSA)30 ng/mL,re-biopsies,incidental PCa after transurethral resection of the prostate(TURP),less than 14 cores or *** of population and subpopulations(with or without PCa)was performed by statistical methods which included ManneWhitney(U test),KruskaleWallis test,Chi-squared statistic,logistic *** logistic regression models predicting mean probability of PCa detection were ***:PCa detection rate was 46.03%.Age,PSA,prostate volume(PV),prostate intraepithelial neoplasia(PIN)and CII were the significant independent predictors of PCa ***(OR Z 0.934)and CII(OR Z 0.192)were both negative independent *** was a significant negative independent predictor in multivariate logistic regression models predicting the mean probability of PCa detection by age,PSA and *** inverse association of CII with PCa does not necessary mean protection because of PSA ***:In a population of patients undergoing prostate first biopsy set,CII was a strong negative independent predictor of PCa *** type Ⅳ should be considered as an adjunctive parameter in re-biopsy or active surveillance protocols.

关键词： Prostate Prostate cancer Prostate specific antigen Prostate biopsy Chronic inflammation Prostate volume Biopsy Gleason score

Clinical implications of endogenous testosterone density on prostate cancer progression in patients with very favorable low and intermediate risk treated with radical prostatectomy

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Asian Journal of Andrology 2023年第5期25卷 556-563页

作者： antonio benito porcaro Alessandro Tafuri Andrea Panunzio Clara Cerrato Alberto Bianchi Sebastian Gallina Stefano Vidiri Damiano D'Aietti Emanuele Serafin Giovanni Mazzucato Alessandro Princiotta Davide Brusa Matteo Brunelli Vincenzo Pagliarulo Maria Angela Cerruto AlessandroAntonelli Department of Urology University of VeronaIntegrated University Hospital of VeronaVerona 37126Italy Department of Urology Vito Fazzi HospitalLecce 73100Italy Department of Pathology University of VeronaIntegrated University Hospital of VeronaVerona 37126Italy

We tested the association between endogenous testosterone density(ETD;the ratio between endogenous testosterone[ET]and prostate volume)and prostate cancer(PCa)aggressiveness in very favorable low-and intermediate-risk PCa patients who underwent radical prostatectomy(RP).Only patients with prostate-specific antigen(PSA)within 10 ng ml^(-1),clinical stage T1c,and International Society of Urological Pathology(IsUP)grade group 1 or 2 were *** ET levels up to 350 ng dl^(-1)were classified as *** quantitation density factors were evaluated as the ratio between percentage of biopsy-positive cores and prostate volume(biopsy-positive cores density,BPCD)and the ratio between percentage of cancer invasion at final pathology and prostate weight(tumor load density,TLD).Disease upgrading was coded as ISUP grade group>2,and progression as recurrence(biochemical and/or local and/or distant).Risk associations were evaluated by multivariable Cox and logistic regression *** 320 patients,151(47.2%)had intermediate-risk ***(median:402.3 ng dl^(-1))resulted abnormal in 111(34.7%)cases(median ETD:9.8 ng dl^(-1)ml^(-1)).Upgrading and progression occurred in 109(34.1%)and 32(10.6%)cases,*** was predicted by ISUP grade group 2(hazard ratio[HR]:2.290;P=0.029)and upgrading(HR:3.098;P=0.003),which was associated with ISUP grade group 2(odds ratio[OR]:1.785;P=0.017)and TLD above the median(OR:2.261;P=0.001).After adjustment for PSAdensity and bodymass index(BMI),ETDabovethemedianwas positivelyassociatedwithBPCD(OR:3.404;P<0.001)and TLD(OR:5.238;P<0.001).Notably,subjects with abnormal ET were more likely to have higher BPCD(OR:5.566;P=0.002),as well as TLD(OR:14.998;P=0.016).Independently by routinely evaluated factors,as ETD increased,BPCD and TLD increased,but increments were higher for abnormal ET *** very favorable cohorts,ETD may further stratify the risk of aggressive PCa.

关键词： endogenous testosterone density prostate cancer radical prostatectomy tumor progression

Briganti’s 2012 nomogram is an independent predictor of prostate cancer progression in EAU intermediate-risk class:results from 527 patients treated with robotic surgery

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Asian Journal of Andrology 2024年第6期26卷 587-591页

作者： antonio benito porcaro Francesca Montanaro Alberto Baielli Francesco Artoni Claudio Brancelli Sonia Costantino Andrea Franceschini Sebastian Gallina Alberto Bianchi Emanuele Serafin Alessandro Veccia Riccardo Rizzetto Matteo Brunelli Filippo Migliorini Salvatore Siracusano Maria Angela Cerruto Riccardo Giuseppe Bertolo Alessandro Antonelli Department of Urology University of VeronaIntegrated University HospitalVerona 37126Italy Department of Pathology University of VeronaIntegrated University HospitalVerona 37126Italy Department of Life Health and Environmental SciencesUniversity of L’AquilaL’Aquila 67100Italy

The study aimed to test if Briganti’s 2012 nomogram could be associated with the risk of prostate cancer (PCa) progression in European Association of Urology (EAU) intermediate-risk patients treated with robotic surgery. From January 2013 to December 2021, 527 consecutive patients belonging to the EAU intermediate-risk class were selected. Briganti’s 2012 nomogram, which predicts the risk of pelvic lymph node invasion (PLNI), was assessed as a continuous and dichotomous variable that categorized up to the median of 3.0%. Disease progression defined as biochemical recurrence and/or metastatic progression was evaluated by Cox proportional hazards (univariate and multivariate analysis). After a median follow-up of 95.0 months (95% confidence interval [CI]: 78.5–111.4), PCa progression occurred in 108 (20.5%) patients who were more likely to present with an unfavorable nomogram risk score, independently by the occurrence of unfavorable pathology including tumor upgrading and upstaging as well as PLNI. Accordingly, as Briganti’s 2012 risk score increased, patients were more likely to experience disease progression (hazard ratio [HR] = 1.060;95% CI: 1.021–1.100;P = 0.002);moreover, it also remained significant when dichotomized above a risk score of 3.0% (HR = 2.052;95% CI: 1.298–3.243;P < 0.0001) after adjustment for clinical factors. In the studied risk population, PCa progression was independently predicted by Briganti’s 2012 nomogram. Specifically, we found that patients were more likely to experience disease progression as their risk score increased. Because of the significant association between risk score and tumor behavior, the nomogram can further stratify intermediate-risk PCa patients, who represent a heterogeneous risk category for which different treatment paradigms exist.

关键词： biochemical recurrence Briganti’s 2012 nomogram intermediate-risk prostate cancer pelvic lymph node invasion prostate cancer progression robot-assisted radical prostatectomy

Association between ABO blood group and unfavorable prostate cancer features after radical prostatectomy:Retrospective study of 1149 patients

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Current Urology 2022年第4期16卷 256-261页

作者： antonio benito porcaro Nelia Amigoni Riccardo Rizzetto Filippo Migliorini Alessandro Tafuri Pierluigi Piccoli Leone Tiso Mario De Michele Alberto Bianchi Sebastian Gallina Paola Irene Ornaghi Rossella Orlando Francesco Cianflone Alessandra Gozzo Stefano Zecchini antoniolli Vincenzo Lacola Matteo Brunelli Maria Angela Cerruto Walter Artibani Alessandro Antonelli Department of Urology University of VeronaAzienda Ospedaliera Universitaria IntegrataVerona137126Italy Department of Neuroscience Imaging and Clinical Sciences"G.d'Annunzio"UniversityChietiItaly Department of Transfusion Medicine University of VeronaAzienda Ospedaliera Universitaria IntegrataVeronaItaly Department of Pathology University of VeronaAzienda Ospedaliera Universitaria IntegrataVeronaItaly

Objectives:To test hypothesized associations between the ABO blood group(ABO-bg)system and the pathological features of prostate cancer(PCa).Material and methods:Between January 2013 and September 2019,1173 patients underwent radical *** between ABO-bg levels and pathological features were evaluated using statistical ***:Overall,1149 consecutive patients were evaluated using the ABO-bg system,which was represented by O-bg(42.8%)and A-bg(41.3%),followed by B-bg(11.1%)and AB-bg(4.8%).Only positive surgical margins(PSMs)was correlated with ABO-bg(Pearson correlation coefficient,r=0.071;p=0.017),and the risk was increased in group-O(odds ratio[OR],1.497;95%confidence interval,1.149-1.950;p=0.003)versus *** clinical and pathological models,O-bg was at increased risk of PSM after the adjustment for prostate-specific antigen,percentage of biopsy-positive cores,and high surgical volume(adjusted OR,1.546;95%confidence interval,1.180-2.026;p=0.002);however,the adjusted OR did not change after the adjustment for tumor load and stage as well as high surgical ***:In clinical PCa,the risk of PSM was higher in O-bg versus non-O-bg patients after the adjustment for standard *** studies are needed to confirm the association between ABO-bg and unfavorable PCa features.

关键词： ABO blood system Prostate cancer Radical prostatectomy Tumor load Tumor stage

High body mass index predicts multiple prostate cancer lymph node metastases after radical prostatectomy and extended pelvic lymph node dissection

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Asian Journal of Andrology 2020年第3期22卷 323-329页

作者： antonio B porcaro Alessandro Tafuri Marco Sebben Tania Processali Marco Pirozzi Nelia Amigoni Riccardo Rizzetto Aliasger Shakir Maria Angela Cerruto Matteo Brunelli Salvatore Siracusano Walter Artibani Department of Urology Azienda Ospedaliera Universitaria Integrata VeronaVerona 37126Italy USC Institute of Urology and Catherine and Joseph Aresty Department of Urology Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA 90033USA Department of Pathology Azienda Ospedaliera Universitaria Integrata VeronaVerona 37126Italy.

Our aim is to evaluate the association between body mass index(BMI)and preoperative total testosterone(TT)levels with the risk of single and multiple metastatic lymph node invasion(LNI)in prostate cancer patients undergoing radical prostatectomy and extended pelvic lymph node *** BMI,basal levels of TT,and prostate-specific antigen(PSA)were evaluated in 361 consecutive patients undergoing radical prostatectomy with extended pelvic lymph node dissection between 2014 and 2017・Patients were grouped into either nonmetastatic,one,or more than one metastatic lymph node invasion *** association among clinical factors and LNI was *** was detected in 52(14.4%)patients:28(7.8%)cases had one metastatic node and 24(6.6%)had more than one metastatic *** the overall study population,BMI correlated inversely with TT(r=-0.256;P28 kg m^2(P28 kg m^2(P-0.048).In our study,overweight and obese patients had a higher risk of harboring multiple prostate cancer lymph node metastases and lower TT levels when compared to patients with normal BMI.

关键词： body mass index metastatic prostate cancer multiple lymph node invasion overweight-obesity preoperative testosterone level

Prostate cancer volume associates with preoperative plasma levels of testosterone that independently predicts high grade tumours which show low densities(quotient testosterone/tumour volume)

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Asian Journal of Urology 2016年第1期3卷 26-32页

作者： antonio B.porcaro Aldo Petrozziello Matteo Brunelli Filippo Migliorini Giovanni Cacciamani Davide De Marchia Nicolo’de Luyk Irene Tamanini Beatrice Caruso Maria A.Cerruto Claudio Ghimenton Walter Artibani Clinica Urologica Ospedale Policlinico ed Ospedale Civile MaggioreAzienda Ospedaliera Universitaria IntegrataVeronaItaly Medicina Interna/Endocrinologia Ospedale Policlinico ed Ospedale Civile MaggioreAzienda Ospedaliera Universitaria IntegrataVeronaItaly Anatomia Patologica Ospedale Policlinico ed Ospedale Civile MaggioreAzienda Ospedaliera Universitaria IntegrataVeronaItaly Medicina di Laboratorio Ospedale Policlinico ed Ospedale Civile MaggioreAzienda Ospedaliera Universitaria IntegrataVeronaItaly

Objective:To investigate potential associations of preoperative total testosterone(TT)with tumor volume(TV)and grade of prostate cancer(PCa).Methods:Patients who were under medications impacting on the hypothalamic-pituitaryadrenal-testis-prostate axis were *** was measured preoperatively at least 1 month after biopsies and TV was calculated on the removed prostate *** continuous variables included total prostate specific antigen(PSA),percentage of positive cores(Pt)and weight(W)of the removed *** were categorized according to the pathologic Gleason score(pGS)in 3 groups(pGS 6,7 and>7).Invasion of the seminal vesicles was coded as seminal vesicle invasion(SVI).Results:The median levels of TT were significantly and increasingly higher from pGS 6(14.7 nmol/L)to pGS 7(15.0 nmol/L)and pGS>7(18.8 nmol/L).The median values of TV were also detected significantly and increasingly higher from pGS 6(5.6 mL)to pGS 7(8.1 mL)and pGS>7(14.8 mL).The median preoperative levels of PSA were also increasing from pGS 6(5.9 μg/L)to pGS 7(6.2 μg/L)and pGS>7(7.7 μg/L).There was a significant and positive correlation of TV to PSA,TT and *** linear regression analysis showed that TV was significantly and independently predicted by TT,PSA and *** grade PCa(pGS>7)independently associated with TV,TT,Pt and *** median density values of TT relative to TV(quotient TT/TV)significantly decreased from pGS 6(2.6 nmol/L/mL)to pGS 7(1.9 nmol/L/mL)and pGS>7(1.4 nmol/L/mL).The median density values of PSA relative to TV(quotient PSA/TV)also significantly decreased from pGS(1.1 μg/L/mL)to pGS 7(0.7 μg/L/mL)and pGS>7(0.6 μg/L/mL).Conclusion:The investigation shows that TT relates to volume and grade of PCa;moreover,the density of TT relative to TV inversely associates with rate of increase of cancer that depends on the grade of the tumour.

关键词： Total testosterone Tumour volume Prostate-specific antigen Prostate cancer Pathology Gleason score

Robotic assisted radical prostatectomy accelerates postoperative stress recovery: Final results of a contemporary prospective study assessing pathophysiology of cortisol peri-operative kinetics in prostate cancer surgery

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Asian Journal of Urology 2016年第2期3卷 88-95页

作者： antonio B.porcaro Nicolo`de Luyk Paolo Corsi Marco Sebben Alessandro Tafuri Davide Inverardi Davide De Marchi Irene Tamanini Matteo Brunelli Maria Angela Cerruto Gian Luca Salvagno Gian Cesare Guidi Walter Artibani Urologic Clinic University HospitalOspedale PoliclinicoAzienda Ospedaliera Universitaria IntegrataVeronaItaly Department of Pathology University HospitalOspedale PoliclinicoAzienda Ospedaliera Universitaria IntegrataVeronaItaly Department of Laboratory Medicine University HospitalOspedale PoliclinicoAzienda Ospedaliera Universitaria IntegrataVeronaItaly

Objective:To investigate the effects of prostate cancer(PCa)surgery on the stress system and to identify potential independent factors associating with stress ***:The design of the study was prospective and PCa surgery included robot assisted radical prostatectomy(RARP)or retropubic radical prostatectomy(RRP).Between February 2013 to December 2014,315 consecutive patients were *** effects of PCa surgery on the stress system were measured by cortisol serum levels before and after surgery on postoperative day(POD)0,1,3,5 and *** variations in the population and subpopulation(RARP ***)of patients were investigated by statistical *** associating with stress recovery were assessed by simple linear regression(SLR)and multiple linear regression(MLR)***:RARP was performed in 75.9%of *** the patient population,there were wide serum cortisol perioperative *** surgery triggered the stress system which immediately(POD 0)responded by cortisol overproduction which induced the negative feedback mechanism that started on POD 1,continued on POD 3,was still ongoing on POD 5 and completely settled on POD 45(stress recovery).In the subpopulation of patients,significantly lower cortisol serum levels were detected on POD 3e5 in RARP cases inwhomcortisol levels were close to preoperative levels(stress recovery)on POD *** predictive factors of serum cortisol on POD 5(stress recovery)were preoperative cortisol(p Z 0.02),cortisol levels on POD 3(p<0.0001)and RARP(p Z 0.03)in which the association was negative(stress recovery faster than RRP).Conclusion:Our study shows that PCa surgery immediately(POD 0)triggers the stress system which respond by overproduction of cortisol which induces the negative feedback mechanism that starts on POD 1,is still ongoing on POD 5,but is completely settled on POD ***,after surgical trauma,our study gives evidence that the RARP procedure associates with stress recovery

关键词： Prostate cancer Robot assisted radical prostatectomy Retropubic radical prostatectomy Stress system