Browsing by Author "Cantiello, F"
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- Metabolic syndrome diagnosis and widespread high grade prostatic intraepithelial neoplasia significantly increase prostate cancer risk: results from a multicenter biopsy study.Publication . Cicione, A; De Nunzio, C; Tubaro, A; Cantiello, F; Manno, S; Oliveira, C; Lima, E; Damiano, RBACKGROUND: To test in multicenter setting if patients affected of metabolic syndrome (MetS) and initial widespread high grade prostatic intraepithelial neoplasia (wHGPIN) diagnosis are at higher risk of prostate cancer (PCa) on repeat biopsy. METHODS: Patients clinical charts from three European Academic Hospital were reviewed in order to identify patients with initial diagnosis of HGPIN undergone to repeat biopsy. Inclusion and exclusion criteria were adopted to minimize patient heterogeneity. MetS was defined according to Word Heart Organization criteria while initial wHGPIN when ≥4 cores biopsy were involved. A multivariate logistic model was computed to assess the association between PCa and clinical-pathological variables. RESULTS: Overall 283 patients were scheduled. Median age was 67 years (IQR 62-72). MetS was diagnosed in 116/283 (41 %) patients and PCa was detected in 84/283 (29.7 %) patients. In particular, PCa was more frequently diagnosed in patients affected of wHGPIN and MetS (45/86, 52.3 %) than in patients with wHGPIN and normal metabolic profile (28/95, 29.5 %), p = 0.002. The multivariate logistic model confirmed that wHGPIN and MetS are independent risk factors for following PCa diagnosis, respectively OR 2.4 (95 % CI 1.01-5.71, p = 0.04), OR 2.79 (95 % CI 1.49-5.22, p = 0.01) while total PSA and DRE findings are not able to predict PCa at repeat biopsy, OR 1.05 (95 % CI 0.98-1.03 p = 0.69) and OR 1.01 (95 % CI 0.55-1.84, p = 0.96) respectively. CONCLUSIONS: wHGPIN is positively associated to PCa; assessing metabolic profile and repeat prostate biopsy is advisable in patients with initial diagnosis of wHGPIN.
- Retropubic, laparoscopic and mini‑laparoscopic radical prostatectomy: a prospective assessment of patient scar satisfactionPublication . Quattrone, C; Cicione, A; Oliveira, C; Autorino, R; Cantiello, F; Mirone, V; De Sio, M; Carrubbo, L; Damiano, R; Pavone, C; Lima, EPURPOSE: To compare patient scar satisfaction after retropubic, standard laparoscopic, mini-laparoscopic (ML) and open radical prostatectomy (RP). METHODS: Patients undergoing RP for a diagnosis of localized prostate cancer at a single academic hospital between September 2012 and December 2013 were enrolled in this prospective nonrandomized study. The patients were included in three study arms: open surgery, VLP and ML. A skin stapler was used for surgical wound closure in all cases. Demographic and main surgical outcomes, including perioperative complications, were analyzed. Surgical scar satisfaction was measured using the Patient and Observer Scar Assessment Questionnaire (POSAS) and the two Body Image Questionnaire (BIQ) scales, respectively, recorded at skin clips removal and either at 6 months after surgery. RESULTS: Overall, 32 patients were enrolled and completed the 6 month of follow-up. At clips removal, laparoscopic approaches offered better scar result than open surgery according to the POSAS. However, at 6 months, no differences were detected between VLP and open, whereas ML was still associated with a better scar outcome (p = 0.001). This finding was also confirmed by both BIQ scales, including the body image score (ML 9.8 ± 1.69, open 15.73 ± 3.47, VLP 13.27 ± 3.64; p = 0.001) and the cosmetic score (ML 16.6 ± 4.12, open 10 ± 1.9, LP 12.91 ± 3.59; p = 0.001). Small sample size and lack of randomization represent the main limitations of this study. CONCLUSIONS: ML RP offers a better cosmetic outcome when compared to both open and standard laparoscopic RP, representing a step toward minimal surgical scar. The impact of scar outcome on RP patients' quality of life remains to be determined.