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The association of type and number of high-risk criteria with cancer-specific mortality in prostate cancer patients treated with radical prostatectomy

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CURRENT UROLOGY 2024年第2期18卷 128-132页

作者： Chierigo, francesco Flammia, Rocco Simone Sorce, Gabriele Hoeh, Benedikt Hohenhorst, Lukas Panunzio, Andrea Tian, Zhe Saad, Fred Graefen, Marcus Gallucci, Michele Briganti, Alberto montorsi, francesco Chun, Felix K. H. Shariat, Shahrokh F. Antonelli, Alessandro Guano, Giovanni Mantica, Guglielmo Borghesi, Marco Suardi, Nazareno Terrone, Carlo Karakiewicz, Pierre I. Univ Genoa Dept Surg & Integrated Diagnost Sci Genoa Italy IRCCS Osped Policlin San Martino Genoa Italy Univ Montreal Hlth Ctr Div Urol Canc Prognost & Hlth Outcomes Unit Montreal PQ Canada IRCCS Policlin San Martino Dept Urol Genoa Italy Univ Genoa Policlin San Martino Hosp Dept Urol Largo Rosanna Benzi 10 I-16132 Genoa Italy Sapienza Rome Univ Policlin Umberto Hosp 1 Dept Maternal Child & Urol Sci Rome Italy Univ Hosp Frankfurt Dept Urol Frankfurt Germany Univ Hosp Hamburg Eppendorf Martini Klin Prostate Canc Ctr Hamburg Germany Univ Verona Azienda Osped Univ Integrata Verona Dept Urol Verona Italy IRCCS San Raffaele Sci Inst Urol Res Inst Div Expt Oncol Unit Urol Milan Italy Med Univ Vienna Comprehens Canc Ctr Dept Urol Vienna Austria Weill Cornell Med Coll Dept Urol New York NY USA Univ Texas Southwestern Dept Urol Dallas TX USA Charles Univ Prague Fac Med 2 Dept Urol Prague Czech Republic IM Sechenov First Moscow State Med Univ Inst Urol & Reprod Hlth Moscow Russia Univ Jordan Jordan Univ Hosp Dept Special Surg Div Urol Amman Jordan

Objectives: This study aimed to test the association between of type and number of D'Amico high-risk criteria (DHRCs) with cancer-specific mortality (CSM) in high-risk prostate cancer patients treated with radical prostatectomy. Materials and methods: In the Surveillance, Epidemiology, and End Results database (2004-2016), we identified 31,281 radical prostatectomy patients with at least 1 DHRC, namely, prostate-specific antigen (PSA) >20 ng/mL (hrPSA), biopsy Gleason Grade Group (hrGGG) score of 4 and 5, or clinical tumor stage >= T3 (hrcT). Multivariable Cox regression models and competing risks regression models (adjusting for other cause mortality) tested the association between DHRCs and 5-year CSM. Results: Of 31,281 patients, 14,394 (67%) exclusively harbored hrGGG, 3189 (15%) harbored hrPSA, and 1781 (8.2%) harbored hrcT. Only 2132 patients (6.8%) harbored a combination of the 2 DHRCs, and 138 (0.6%) had all 3 DHRCs. Five-year CSM rates ranged from 0.9% to 3.0% when any individual DHRC was present (hrcT, hrPSA, and hrGGG, in that order), 1.6% to 5.9% when 2 DHRCs were present (hrPSA-hrcT, hrcT-hrGGG, and hrPSA-hrGGG, in that order), and 8.1% when all 3 DHRCs were present. Cox regression models and competing risks regression confirmed the independent predictor status of DHRCs for 5-year CSM that was observed in univariable analyses, with hazard ratios from 1.00 to 2.83 for 1 DHRC, 2.35 to 5.88 for combinations of 2 DHRCs, and 7.13 for all 3 DHRCs. Conclusions: Within individual DHRCs, hrcT and hrPSA exhibited weaker effects than hrGGG did. Moreover, a dose-response effect was identified according to the number of DHRCs. Accordingly, the type and number of DHRCs allow further risk stratification within the high-risk subgroup.

关键词： High risk prostate cancer Radical prostatectomy Cancer-specific mortality Staging SEER BEAM RADIATION-THERAPY RATES

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Heavy cigarette smoking and alcohol consumption are associated with impaired sperm parameters in primary infertile men

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Asian Journal of Andrology 2019年第5期21卷 478-485页

作者： Luca Boeri Paolo Capogrosso Eugenio Ventimiglia Filippo Pederzoli Walter Cazzaniga francesco Chierigo Federico Deho Emanuele Montanari francesco montorsi Andrea Salonia Division of Experimental Oncology/Unit of Urology URIIRCCS San Raffaele HospitalMilan 20132Italy Department of Urology Foundation IRCCS Ca'Granda Maggiore Policlinico HospitalUniversity of MilanMilan 20122Italy University Vita-Salute San Raffaele Milan 20132Italy

We assessed the concomitant impact of cigarette smoking and alcohol con sumption in men presenting for primary couple's *** from 189 in fertile men were an a *** analysis,serum hormones,and sperm DNA fragmentation(SDF)were *** status was categorized as follows:current nonsmoker(-S),moderate smoker(+MS),and heavy smoker(+HS).Alcohol consumption was categorized as follows:abstainer(-D),moderate drinker(+MD),and heavy drinker(+HD).Descriptive statistics and logistic regression models were *** all the participants,132(69.8%),30(15.9%),and 27(14.3%)patients were-S,+MS,and+HS,*** addition,67(35.4%),77(40.7%)and 45(23.8%)men were-D,+MD and+HD,*** concomitant habits,52(27.5%)patients were nonsmokers and abstainers(-S/-D:Group 1),91(48.1%)had at least one recreational habit(-S/+D or+S/-D:Group 2),and 46(24.3%)were both smokers and drinkers(+S/+D:Group 3).Sperm concentration and progressive motility were lower in+HS and+HD,compared with-S and-D(all P<0.05),***,both parameters were significantly lower in Group 3 than Groups 1 and 2(all P<0.05).SDF values were higher in Group 3 than Groups 1 and 2(both P<0.05).In multivariate analysis,follicle-stimulating hormone(FSH)levels and concomitant+S/+D status were independent predictors of impaired sperm concentration and progressive motility(all P<0.05).Heavy smoking and heavy drinking were associated with worse seminal parameters than moderate smoking/drinking and nonsmoking/*** concomitant,+S/+D status has an even greater detrimental effect on semen parameters.

关键词： alcohol con sumption cigarette smoki ng in fertility risk factors seme n an alysis

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History and evolution of the use of oral mucosa for urethral reconstruction

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Asian Journal of Urology 2017年第2期4卷 96-101页

作者： Guido Barbagli Sofia Balo francesco montorsi Salvatore Sansalone Massimo Lazzeri Centro Chirurgico Toscano ArezzoItaly Division of Oncology/Unit of Urology IRCCS Ospedale San RaffaeleMilanItaly Department of Experimental Medicine and Surgery University of Tor VergataRomeItaly Department of Urology Istituto Clinico Humanitas IRCCSClinical and Research HospitalRozzanoItaly

We report here the history and evolution of the use of oral mucosa in reconstructive urethral surgery since it was first used for urethroplasty in *** that time,many authors have contributed to develop,improve and popularize the use of oral mucosa as a substitute *** urologists should be considered pioneers on the use of oral mucosa as they used it to repair primary and failed *** use of oral mucosa to repair penile and bulbar urethral strictures was described,for the first time,in *** evolutions in the technique for harvesting oral mucosa from the cheek were reported in ***,oral mucosa is considered the gold standard material for any type of anterior urethroplasty in a one-or two-stage repair due to its biological and structural characteristics that make it a highly versatile that is adaptable to any environment required by the reconstructive urethral *** the future approaches,tissue engineering techniques will provide patients with new materials originating from the oral epithelial mucosal cells,which are cultured and expanded into a ***,the path to reach this ambitious objective is still long and many difficulties must be overcome along the way.

关键词： Oral mucosa Cheek Urethra Urethroplasty Tissue engineering Reconstructive urology

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A novel expressed prostatic secretion(EPS)-urine metabolomic signature for the diagnosis of clinically significant prostate cancer

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Cancer Biology & Medicine 2021年第2期18卷 604-615页

作者： Denise Drago Annapaola Andolfo Ettore Mosca Alessandro Orro Luigi Nocera Vito Cucchiara MatteoBellone francesco montorsi Alberto Briganti ProMeFa Proteomics and Metabolomics FacilityCenter for Omics Sciences(COSR)IRCCS San Raffaele Scientific InstituteMilan 20132Italy Institute of Biomedical Technologies National Research Council(CNR)Milan 20090Italy Department of Urology and Division of Experimental Oncology Urological Research Institute(URI)IRCCS San Raffaele Scientific InstituteMilan 20132Italy Division of Immunology Transplantation and Infectious DiseasesIRCCS San Raffaele Scientific InstituteMilan 20132Italy

Objective:Significant efforts are currently being made to identify novel biomarkers for the diagnosis and risk stratification of prostate cancer(PCa).Metabolomics can be a very useful approach in biomarker discovery because metabolites are an important read-out of the disease when characterized in biological *** aimed to determine a metabolomic signature which can accurately distinguish men with clinically significant PCa from those affected by benign prostatic hyperplasia(BPH).Methods:We first performed untargeted metabolomics using ultrahigh-performance liquid chromatography tandem mass spectrometry on expressed prostatic secretion urine(EPS-urine)from 25 patients affected by BPH and 25 men with clinically significant PCa(defined as Gleason score≥3+4).Diagnosis was histologically confirmed after surgical *** EPS-urine metabolomic approach was then applied to a larger,prospective cohort of 92 consecutive patients undergoing multiparametric magnetic resonance imaging for clinical suspicion of PCa prior to ***:We established a novel metabolomic signature capable of accurately distinguishing PCa from benign tissue.A metabolomic signature was associated with clinically significant PCa in all subgroups of the Prostate Imaging Reporting and Data System(PI-RADS)classification(100%and 89.13%of accuracy when the PI-RADS was in range of 1–2 and 4–5,respectively,and 87.50%in the more critical cases when the PI-RADS was 3).Conclusions:A combination of metabolites and clinical variables can effectively help in identifying PCa patients that might be overlooked by current imaging *** from EPS-urine should help in defining the diagnostic pathway of PCa,thus improving PCa detection and decreasing the number of unnecessary prostate biopsies.

关键词： Prostate cancer EPS-urine metabolomics prediction diagnosis

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Substances of abuse consumption among patients seeking medical help for uro-andrological purposes:a sociobehavioral survey in the real-life scenario

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Asian Journal of Andrology 2021年第5期23卷 456-461页

作者： Federico Belladelli Luca Boeri Paolo Capogrosso Walter Cazzaniga Eugenio Ventimiglia Luigi Candela Edoardo Pozzi Andrea Baudo Massimo Alfano Costantino Abbate francesco montorsi Andrea Salonia Division of Experimental Oncology/Unit of Urology URIIRCCS Ospedale San Raffaelevia Olgettina 60Milan 20131Italy University Vita-Salute San Raffaele via Olgettina 60Milan 20131Italy Department of Urology Foundation IRCCS Ca'Granda-Ospedale Maggiore PoliclinicoUniversity of Milanvia Della Commenda 15Milan 20122Italy

Substances of abuse(SoA),as well as smoking and alcohol consumption,are well known for their impact on male fertility status,erectile function,and *** assessed SoA consumption habits in a cohort of men seeking medical attention for uro-andrological *** from 7447 men seeking medical attention for the first time for uro-andrological purposes were analyzed.A complete medical and sexual history was collected for each ***,alcohol,and SoA consumption were *** statistics was used to describe the whole *** primary motivations for their evaluation were lower urinary tract symptoms(LUTS),erectile dysfunction(ED),and infertility in 1912(25.7%),2944(39.5%),and 2591(34.8%)men,*** use of SoA was reported by 378(5.1%)men,and 190(2.6%)individuals were current *** seeking medical attention for infertility were more frequently current SoA users(107;4.1%)than men with ED(66;2.2%)and LUTS(17;0.9%)(both P<0.001).Current users of SoA were younger than those with past or no SoA history(P<0.001).Current SoA users were more frequently smokers(P<0.001)and alcohol consumers(P<0.001)than those with a previous history or those who had never tried *** conclusion,approximately 3%of men seeking medical attention for uro-andrological purposes were current SoA *** men reported a higher use of SoA than those with ED or *** SoA users were younger and more frequently concomitant smokers and alcohol consumers compared to those who did or had never used SoA.

关键词： cannabis cocaine erectile dysfunction male infertility risk factors substances of abuse

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***-term recovery of normal sexual function in lesticular cancer survivors

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Asian Journal of Andrology 2016年第1期18卷 85-89页

作者： Paolo Capogrosso Luca Boeri Matteo Ferrari Eugenio Ventimiglia Giovanni La Croce Umberto Capitanio Alberto Briganti Rocco Damiano francesco montorsi Andrea Salonia Universita Vita-Salute San Raffaele Milan Italy Division of Experimental Oncology Unit of Urology URI IRCCS Ospedale San Raffaele Milan Italy Research Doctorate Program in Urology Magna Graecia University Catanzaro Italy

Testicular cancer （TC） is the most common solid cancer in men between the third and fourth decade of life. Due to successful treatment approaches, TC survivors （TCSs） have long life expectancy, but with numerous potential long-term sequelae, including sexual dysfunction. We investigated predictors of long-term normal sexual function （SF） recovery in TCSs. Sociodemographic, medical, and psychometric data were analyzed in 143 Caucasian-European TCSs, who underwent orchiectomy at a single institution. Health-significant comorbidities were scored with the Charlson Comorbidity Index （CCI）. Patients completed the International Index of Erectile Function （IIEF）. Statistical models tested the association between predictors （including age at surgery, body mass index, CCI, and adjuvant therapy： radiotherapy [RT], chemotherapy [CT], CT followed by retroperitoneal lymph node dissection [RPLND] and RPLND alone） and the long-term recovery of normal SF （defined as IIEF-erectile function [EF] ≥26, and sexual desire [SD], intercourse satisfaction [IS] orgasmic function [OF], and overall satisfaction [OS] domain scores in the upper tertiles）. At a mean follow-up of 86 months, 35 （25.5%） TCSs had erectile dysfunction （ED）, with 16 （11.2%） experiencing severe ED. Median time of EF recovery was 60, 60, and 70 months after CT, RT, and RPLND, respectively. Only adjuvant RT emerged as an independent predictor of nonrecovery of normal EF （HR： 0.55, P = 0.01）. Neither adjuvant CT nor CT plus RPLND or RPLND alone significantly impaired the recovery of normal erections. Adjuvant therapy was not associated with impaired recovery of normal sexuality as a whole, considering the IIEF-SD, -OF, -IS, and OS domains.

关键词： chemotherapy erectile dysfunction radiotherapy retroperitoneal lymph node dissection survivors testicular cancer

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Metabolic syndrome in White-European men presenting for secondary couple＇s infertility： an investigation of the clinical and reproductive burden

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Asian Journal of Andrology 2017年第3期19卷 368-373页

作者： Eugenio Ventimiglia Paolo Capogrosso Alessandro Serino Luca Boeri Michele Colicchia Giovanni La Croce Roberta Scano Enrico Papaleo Rocco Damiano francesco montorsi Andrea Salonia Division of Experimental Oncology Unit of Urology URI IRCCS Ospedale San Raffaele 20132 Milan Italy University Vita-Salute San Raffaele 20132 Milan Italy Infertility Unit Unit of Obstetrics/Gynecology IRCCS Ospedale San Raffaele 20132 Milan Italy Research Doctorate Program in Urology Magna Graecia University 88020 Catanzaro Italy.

We aimed to determine the impact of metabolic syndrome （MetS） on reproductive function in men with secondary infertility, a condition that has received relatively little attention from researchers. Complete demographic, clinical, and laboratory data from 167 consecutive secondary infertile men were analyzed. Health-significant comorbidities were scored with the Charlson Comorbidity Index （CCI; categorised 0 vs I vs 2 or higher）. NCEP-ATP III criteria were used to define MetS. Semen analysis values were assessed based on the 2010 World Health Organization （WHO） reference criteria. Descriptive statistics and logistic regression models tested the association between semen parameters and clinical characteristics and MetS. MetS was found in 20 （12%） of 167 men. Patients with MetS were older （P 〈 0.001） and had a greater BMI （P 〈 0.001） compared with those without MetS. MetS patients had lower levels of total testosterone （P = 0.001）, sex hormone-binding globulin, inhibin B, and anti-MOIlerian hormone （all P 〈 0.03）, and they were hypogonadal at a higher prevalence （P = 0.01） than patients without MetS. Moreover, MetS patients presented lower values of semen volume, sperm concentration, and sperm normal morphology （all P≤0.03）. At multivariate logistic regression analysis, no parameters predicted sperm concentration, normal sperm morphology, and total progressive motility. Our data show that almost 1 of 8 White-European men presenting for secondary couple＇s infertility is diagnosed with MetS. MetS was found to be associated with a higher prevalence of hypogonadism, decreased semen volume, decreased sperm concentration, and normal morphology in a specific cohort of White-European men.

关键词： infertility metabolic syndrome sperm count

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Sexual dysfunction and prostate cancer risk： one more piece of a complex puzzle

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Asian Journal of Andrology 2017年第2期19卷 264-264页

作者： Paolo Capogrosso francesco montorsi Andrea Salonia University Vita-Salute San Raffaele Milan Italy Division of Experimental Oncology/Unit of Urology URI IRCCS San Raffaele Hospital Milan Italy

In an era of personalized medicine where genetic, environmental, and biometric factors are considered as a whole throughout the diagnostic and therapeutic approach to a disease, the association between several clinica... 详细信息

关键词： Sexual dysfunction prostate cancer risk complex puzzle

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Primary lymphomas of the genitourinary tract:A population-based study

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Asian Journal of Urology 2020年第4期7卷 332-339页

作者： Carlotta Palumbo Elio Mazzone francesco A.Mistretta Sophie Knipper Zhe Tian Paul Perrotte francesco montorsi Shahrokh F.Shariat Fred Saad Claudio Simeone Alberto Briganti Alessandro Antonelli Pierre I.Karakiewicz Cancer Prognostics and Health Outcomes Unit University of Montreal Health CenterMontrealQuebecCanada Urology Unit ASST Spedali Civili of BresciaDepartment of Medical and Surgical SpecialtiesRadiological Science and Public HealthUniversity of BresciaBresciaItaly Division of Experimental Oncology Unit of UrologyUrological Research Institute(URI)IRCCS San Raffaele Scientific InstituteMilanItaly Vita-Salute San Raffaele University MilanItaly Department of Urology European Institute of OncologyMilanItaly Martini Klinik University Medical Center Hamburg-EppendorfHamburgGermany Division of Urology University of Montreal Hospital Center(CHUM)MontrealQuebecCanada Department of Urology Comprehensive Cancer CenterMedical University of ViennaViennaAustria Department of Urology Weill Cornell Medical CollegeNew YorkNYUSA Department of Urology University of Texas SouthwesternDallasTXUSA Department of Urology Second Faculty of MedicineCharles UniversityPragCzech Republic Institute for Urology and Reproductive Health I.M.Sechenov First Moscow State Medical UniversityMoscowRussia

Objective:We performed a population-based analysis focusing on primary extranodal lymphoma of either testis,kidney,bladder or prostate(PGUL).Methods:We identified all cases of localized testis,renal,bladder and prostate primary lymphomas(PL)versus primary testis,kidney,bladder and prostate cancers within the Surveillance,Epidemiology,and End Results database(1998e2015).Estimated annual proportion change methodology(EAPC),multivariable logistic regression models,cumulative incidence plots and multivariable competing risks regression models were ***:The rates of testis-PL,renal-PL,bladder-PL and prostate-PL were 3.04%,0.22%,0.18%and 0.01%,*** with PGUL were older and more frequently *** rates significantly decreased for renal-PL(EAPC:5.6%;pZ0.004)and prostate-PL(EAPC:3.6%;pZ0.03).In multivariable logistic regression models,older ager independently predicted testis-PL(odds ratio[OR]:16.4;p<0.001)and renal-PL(OR:3.5;p<0.001),while female gender independently predicted bladder-PL(OR:5.5;p<0.001).In surgically treated patients,cumulative incidence plots showed significantly higher 10-year cancer-specific mortality(CSM)rates for testis-PL,renal-PL and prostate-PL versus their primary genitourinary *** multivariable competing risks regression models,only testis-PL(hazard ratio[HR]:16.7;p<0.001)and renal-PL(HR:2.52;p<0.001)independently predicted higher CSM ***:PGUL rates are extremely low and on the decrease in kidney and prostate but stable in testis and *** to primary genitourinary tumors,PGUL are associated with worse CSM for testis-PL and renal-PL but not for bladder-PL and prostate-PL,even after adjustment for other-cause mortality.

关键词： Bladder lymphoma Genitourinary neoplasm Genitourinary Primary extranodal lymphoma Prostate lymphoma Renal lymphoma Testis lymphoma Survival

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Testicular volume in infertile versus fertile white-European men: a case-control investigation in the real-life setting

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Asian Journal of Andrology 2021年第5期23卷 501-509页

作者： Luca Boeri Paolo Capogrosso Eugenio Ventimiglia Walter Cazzaniga Edoardo Pozzi Federico Belladelli Filippo Pederzoli Massimo Alfano Costantino Abbate Emanuele Montanari Luca Valsecchi Enrico Papaleo Paola Vigano Patrizia Rovere-Querini Suks Minhas francesco montorsi Andrea Salonia Division of Experimental Oncology/Unit of Urology URIIRCCS Ospedale San RaffaeleVia Olgettina 60Milan 20131Italy Department of Urology Foundation IRCCS Ca'Granda-Ospedale Maggiore PoliclinicoUniversity of MilanVia Della Commenda 15Milan 20122Italy University Vita-Salute San Raffaele Via Olgettina 60Milan 20131Italy Department of Obstetrics and Gynaecology IRCCS Ospedale San RaffaeleVia Olgettina 60Milan 20131Italy Division of Genetics and Cell Biology Reproductive Sciences LaboratoryIRCCS Ospedale San RaffaeleVia Olgettina 60Milan 20131Italy Division of Immunology Transplantation and Infectious Diseases Department of MedicineIRCCS Ospedale San RaffaeleVia Olgettina 60Milan 20131Italy Department of Urology Imperial Healthcare NHS TrustCharing Cross HospitalFulham Palace RoadHammersmithLondon W68RFUK

Testicular volume(TV)is considered a good clinical marker of hormonal and spermatogenic *** reference values for TV measures in infertile and fertile men are *** aimed to assess references values for TV in white-European infertile men and fertile *** analyzed clinical and laboratory data from 1940(95.0%)infertile men and 102(5.0%)fertile *** were matched by age using propensity score *** was assessed using a Prader orchidometer(PO).Circulating hormones and semen parameters were investigated in every *** statistics,Spearman's correlation,and logistic regression models tested potential associations between PO-estimated TV values and clinical *** operating characteristic(ROC)curves were used to find TV value cutoffs for oligoasthenoteratozoospermia(OAT)and nonobstructive azoospermia(NOA)status in infertile *** median testicular volume was smaller in infertile than that of fertile men(15.0 ml vs 22.5 ml;P<0.001).TV positively correlated with total testosterone,sperm concentration,and progressive sperm motility(all P≤0.001)in infertile *** multivariable logistic regression analysis,infertile status(P<0.001)and the presence of left varicocele(P<0.001)were associated with TV<15 *** volume thresholds of 15 ml and 12 ml had a good predictive ability for detecting OAT and NOA status,*** conclusion,infertile men have smaller testicular volume than fertile *** positively correlated with total testosterone,sperm concentration,and progressive motility in infertile men,which was not the case in the age-matched fertile counterparts.

关键词： hypogonadism male infertility orchidometer Prader semen analysis testicular volume

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