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Proficiency score as a predictor of early trifecta achievement during the learning curve of robot-assisted radical prostatectomy for high-risk prostate cancer:Results of a multicentric series

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Current Urology 2024年第2期18卷 110-114页

作者： Umberto Anceschi rocco simone flammia Antonio Tufano Michele Morelli Antonio Galfano Lorenzo Giuseppe Luciani Leonardo Misuraca Paolo Dell’Oglio Gabriele Tuderti Aldo Brassetti Maria Consiglia Ferriero Alfredo Maria Bove Riccardo Mastroianni Francesco Prata Isabella Sperduti Giovanni Petralia SilviaSecco Ettore Di Trapani DanieleMattevi Tommaso Cai Aldo Massimo Bocciardi Giuseppe simone Department of Urology IRCCS“Regina Elena”National Cancer InstituteRomeItaly Urologic Clinic Department of Maternal-Child and Urologic SciencesSapienza University of RomeItaly Ospedale Niguarda Ca’Granda Department of UrologyMilanItaly Department of Urology APSS Santa Chiara Regional HospitalTrentoItaly Department of Biostatistical Unit IRCCS Regina Elena National Cancer InstituteRomeItaly

Background:Recently,an innovative tool called“proficiency score”was introduced to assess the learning curve for robot-assisted radical prostatectomy(RARP).However,the initial study only focused on patients with low-risk prostate cancer forwhompelvic lymph node dissection(PLND)was not *** address this issue,we aimed to validate proficiency scores of a contemporarymulticenter cohort of patients with high-risk prostate cancer treated with RARP plus extended PLND by trainee *** andmethods:Between 2010 and 2020,4 Italian institutional prostate-cancer datasets weremerged and queried for“RARP”and“high-risk prostate cancer.”High-risk prostate cancer was defined according to the most recent European Association of Urology guidelines as follows:prostate-specific antigen>20 ng/mL,International Society ofUrological Pathology≥4,and/or clinical stage(cT)≥2c on preoperative *** selected cohort(n=144)included clinical cases performed by trainee surgeons(n=4)after completing their RARP learning curve(50 procedures for low-risk prostate cancer).The outcome of interest,the proficiency score,was defined as the coexistence of all the following criteria:a comparable operation time to the interquartile range of the mentor surgeon at each center,absence of any significant perioperative complications Clavien-Dindo Grade 3–5,no perioperative blood transfusions,and negative surgical margins.A logistic binary regression model was built to identify the predictors of 1-year trifecta achievement in the trainee *** all statistical analyses,a 2-sided p<0.05 was considered ***:A proficiency score was achieved in 42.3%*** univariable level,proficiency score was associated with 1-year trifecta achievement(odds ratio,8.77;95%confidence interval,2.42–31.7;p=0.001).After multivariable adjustments for age,nerve-sparing,and surgical technique,the proficiency score independently predicted 1-year trifecta achievement(odds ratio,9.58;95%confidence i

关键词： Trifecta Learning curve Robot-assisted radical prostatectomy High-risk prostate cancer

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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： Francesco Chierigo rocco simone flammia GabrieleSorce Benedikt Hoeh Lukas Hohenhorst Andrea Panunzio Zhe Tian Fred Saad Marcus Graefen Michele Gallucci Alberto Briganti Francesco Montorsi Felix K.H.Chun Shahrokh F.Shariat Alessandro Antonelli Giovanni Guano Guglielmo Mantica Marco Borghesi Nazareno Suardi Carlo Terrone Pierre I.Karakiewicz Department of Surgical and Diagnostic Integrated Sciences University of GenovaGenovaItaly IRCCS Ospedale Policlinico San Martino GenovaItaly Cancer Prognostics and Health Outcomes Unit Division of UrologyUniversity ofMontréal Health CenterMontréalQuébecCanada Department of Urology IRCCS Policlinico San MartinoGenovaItaly Department of Maternal-Child and Urological Sciences Sapienza Rome UniversityPoliclinico Umberto I HospitalRomeItaly Department of Urology University Hospital FrankfurtFrankfurt am MainGermany Martini-Klinik Prostate Cancer Center University Hospital Hamburg-EppendorfHamburgGermany Department of Urology University of VeronaAzienda Ospedaliera Universitaria Integrata di VeronaVeronaItaly Division of Experimental Oncology/Unit of Urology URIUrological Research InstituteIRCCS San Raffaele Scientific InstituteMilanItaly 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 UniversityPragueCzech Republic Institute for Urology and Reproductive Health I.M.Sechenov First Moscow State Medical UniversityMoscowRussia Division of Urology Department of Special SurgeryJordan University HospitalThe University of JordanAmmanJordan

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 *** 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 ***:Of 31,281 patients,14,394(67%)exclusively harbored hrGGG,3189(15%)harbored hrPSA,and 1781(8.2%)harbored *** 2132 patients(6.8%)harbored a combination of the 2 DHRCs,and 138(0.6%)had all 3 ***-year CSMrates 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 *** 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 ***:Within individual DHRCs,hrcT and hrPSA exhibited weaker effects than hrGGG ***,a dose-response effect was identified according to the number of ***,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

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Autoimmune liver diseases and SARS-CoV-2

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World Journal of Gastroenterology 2023年第12期29卷 1838-1851页

作者： Costantino Sgamato Alba rocco Debora Compare Stefano Minieri Stefano Andrea Marchitto simone Maurea Gerardo Nardone Department of Clinical Medicine and Surgery University of Naples Federico ⅡNaples 80131Italy Department of Advanced Biomedical Sciences University of Naples Federico ⅡNaples 80131Italy

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),causing coronavirus disease 2019(COVID-19),can trigger autoimmunity in genetically predisposed individuals through hyperstimulation of immune response and molecular *** we summarise the current knowledge about autoimmune liver diseases(AILDs)and SARS-CoV-2,focusing on:(1)The risk of SARS-CoV-2 infection and the course of COVID-19 in patients affected by AILDs;(2)the role of SARS-CoV-2 in inducing liver damage and triggering AILDs;and(3)the ability of vaccines against SARS-CoV-2 to induce autoimmune responses in the *** derived from the literature suggest that patients with AILDs do not carry an increased risk of SARS-Cov-2 infection but may develop a more severe course of COVID-19 if on treatment with steroids or *** SARSCoV-2 infection can lead to the development of several autoimmune diseases,few reports correlate it to the appearance of de novo manifestation of immunemediated liver diseases such as autoimmune hepatitis(AIH),primary biliary cholangitis(PBC)or AIH/PBC overlap *** case series of an AIHlike syndrome with a good prognosis after SARS-CoV-2 vaccination have been *** the causal link between SARS-CoV-2 vaccines and AIH cannot be definitively established,these reports suggest that this association could be more than coincidental.

关键词： Autoimmune liver disease SARS-CoV-2 COVID-19 COVID-19 vaccine Autoimmune hepatitis

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Gastric laceration after cardiopulmonary resuscitation:A case report

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Case Reports in Clinical Medicine 2014年第1期3卷 52-56页

作者： Rita simone Lopes Moreira Solange Guizilini Natasha Marcondes Ramiro Colleoni Isadora S.rocco Iran Goncalves Ana Christina Velloso Caluza Vinicius Santos Batista Antonio Carlos de Camargo Carvalho Hospital Sao Paulo-University Hospital of Federal University of Sao Paulo Sao PauloBrazil Department of Cardiology Federal University of Sao PauloSao PauloBrazil

The cardiopulmonary resuscitation (CPR) persists as the best practice to maintain cerebral and coronary perfusion after cardiac arrest. Due to the chest compressions and ventilation maneuvers during resuscitation, there are common complications reported. Abdominal organs injuries occur in approximately 30% of patients, although studies show that they are under diagnosticated. The aim of this article is to report a case of massive digestive hemorrhage by gastric laceration after cardiopulmonary resuscitation, due to the event severity and rare clinic diagnostic. A 75-year-old Caucasian man suffered a sudden malaise and cardiac arrest and transferred to an Emergency Unit (EU). The set of measures recommended by Advanced Cardiac Life Support (ACLS) was performed. Despite no resistance to the passage of nasogastric survey and spontaneous healing of fresh blood exteriorization, an endoscopy showed ulcers in gastric notch with clots adhered and active blood. There was no track record of liver or gastrointestinal diseases on this patient, identifying a gastric laceration after cardiopulmonary resuscitation. The mechanism by which the gastric laceration after CPR occurred is uncertain. Nevertheless, some precipitating factors are considered such as positioning of the patient during CPR, ideal point of compressions and ventilation pressure. In conclusion, this event is rare with a hard diagnostic however that could be avoided and minimized with preventive measures.

关键词： Cardiac Arrest Ventilation Emergency Care Complications Gastric Injury Cardiopulmonary Resuscitation

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Safety and efficacy of DEM-TACE performed with drug-eluting microspheres smaller than 300μm in patients with HCC and TIPS

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Hepatoma Research 2022年第1期8卷 193-206页

作者： Pierleone Lucatelli simone Zilahi De Gyurgyokai Gianluca De Rubeis Renato Argirò simone Ciaglia Bianca rocco Flaminia Ferri Simona Parisse Mariana Forlino Alessandro Cannavale FabrizioBasilico Pier Giorgio Nardis Mario Corona Vito Cantisani Carlo Catalano Vascular and Interventional Radiology Unit Department of Radiological Oncological and Anatomo-Pathological SciencesPoliclinico Umberto I Sapienza University of RomeViale Regina Elena 324Rome 00161Italy Department of Interventional Radiology San Camillo Forlanini HospitalCirconvallazione Gianicolense 87Rome 00152Italy Department of Imaging and Interventional Radiology Azienda Ospedaliera Universitaria Policlinico Tor VergataViale Oxford 81Rome 00133Italy Department of Translational and Precision Medicine Sapienza University of RomeViale Regina Elena 324Rome 00161Italy Department of Radiology Policlinico Umberto I Sapienza University of RomeViale Regina Elena 324Rome 00161Italy

Aim:Safety and efficacy evidence of drug-eluting-microspheres trans-arterial chemoembolization(DEM-TACE)in patients with hepatocellular carcinoma(HCC)and trans-jugular intrahepatic portosystemic shunt(TIPS)is *** aim of this retrospective study was to report the safety and efficacy of DEM-TACE procedures performed with microspheres smaller than 300μm in patients with HCC and TIPS in a high-volume transplant ***:Embolization was standardized by initiating DEM-TACE with microspheres smaller than 100μm,and if stasis was not achieved,adjunctive embolization with 100-300 or 200μm microspheres was *** regards to efficacy,the oncological response was evaluated and categorized according to mRECIST criteria at 1,3-6,9-12,and 15-18 *** the safety profile,detailed laboratory analysis was performed before,at 36-48 h,and 30-60 days after the *** events(AEs)were recorded;post-embolic syndrome was defined as the onset of fever/nausea/pain after the *** onset hepatobiliary complications were evaluated by follow-up imaging with computed tomography or magnetic resonance(CT/MR).Results:From December 2007 to November 2020,17 HCC patients(25 HCC nodules)with patent TIPS underwent 20 *** was performed only with microspheres smaller than 100μm in 3/20 DEM-TACE(15%);adjunctive embolization with 100-300 or 200μm microspheres was required in 17/20 DEMTACE(85%).Reported early AEs were post-embolic syndrome(9/20;45%)all of grade 1-2,late AEs were asymptomatic acute liver bile duct injury(2/20;10%),and in one case we observed hepatic abscess(1/20;5%)resulting in death due to *** regards to efficacy,the oncological response was evaluated and categorized according to mRECIST *** response(CR)at 1,3-6,9-12,and 15-18 months was 52%,50%,50%,and 50%,*** response(CR+partial response)at 1,3-6,9-12,and 15-18 months was 95%,71%,70%,and 50%,***:DEM-TACE with

关键词： HCC TIPS DEM-TACE CT MR

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