Learning in Non-Cooperative Configurable Markov Decision Processes

The Configurable Markov Decision Process framework includes two entities: a Reinforcement Learning agent and a configurator that can modify some environmental parameters to improve the agent's performance. This presupposes that the two actors have the same reward functions. What if the configurator does not have the same intentions as the agent? This paper introduces the Non-Cooperative Configurable Markov Decision Process, a setting that allows having two (possibly different) reward functions for the configurator and the agent. Then, we consider an online learning problem, where the configurator has to find the best among a finite set of possible configurations. We propose two learning algorithms to minimize the configurator's expected regret, which exploits the problem's structure, depending on the agent's feedback. While a naive application of the UCB algorithm yields a regret that grows indefinitely over time, we show that our approach suffers only bounded regret. Furthermore, we empirically show the performance of our algorithm in simulated domains

The extent of pelvic lymph node dissection correlates with the biochemical recurrence rate in patients with intermediate- and high-risk prostate cancer.

OBJECTIVE: • To assess the impact of pelvic lymph node dissection (PLND) and of the number of lymph nodes (LNs) retrieved during radical prostatectomy (RP) on biochemical relapse (BCR) in pNX/0/1 patients with prostate cancer according to the clinical risk of lymph node invasion (LNI). PATIENTS AND METHODS: • We evaluated 872 pT2-4 NX/0/1 consecutive patients submitted to RP between October 1995 and June 2009, with the following inclusion criteria: (i) a follow-up period ≥12 months; (ii) the avoidance of neoadjuvant hormonal therapy or adjuvant hormonal and/or adjuvant radiotherapy; (iii) the availability of complete follow-up data; (iv) no pathological T0 disease; (v) complete data regarding the clinical stage and Gleason score (Gs), the preoperative prostate-specific antigen (PSA) level and the pathological stage. • The patients were stratified as having low risk (cT1a-T2a and cGs ≤6 and PSA level < 10 ng/mL), intermediate risk (cT2b-T2c or cGs = 7 or PSA level = 10-19.9) or high risk of LNI (cT3 or cGs = 8-10 or PSA level ≥ 20). • The 872 patients were divided into two LN groups according to the number of LNs retrieved: group 1 had no LN or one to nine LNs removed; group 2 had 10 or more LNs. • The variables analysed were LN group, age, PSA level, clinical and pathological stage and Gs, surgical margin status, LN status and number of LN metastases; the primary endpoint was the BCR-free survival. RESULTS: • The mean follow-up was 55.8 months. • Of all the patients, 305 (35%) were pNx and 567 (65.0%) were pN0/1. • Of the 567 patients submitted to PLND, the mean number of LNs obtained was 10.9, and 49 (8.6%) were pN1. • In the 402 patients at low risk of LNI, LN group was not a significant predictor of BCR at univariate analysis, while in the 470 patients at intermediate and high risk of LNI, patients with ≥ 10 LNs removed had a significantly lower BCR-free survival at univariate and multivariate analysis. CONCLUSION: • In our study population, a more extensive PLND positively affects the BCR-free survival regardless of the nodal status in intermediate- and high-risk prostate cancer

NEFRECTOMIA PARZIALE LAPAROSCOPICA VS OPEN:IMPATTO DELLA CURVA DI APPRENDIMENTO SUI RISULTATI ONCOLOGICI E FUNZIONALI

NEFRECTOMIA PARZIALE LAPAROSCOPICA VS OPEN:IMPATTO DELLA CURVA DI APPRENDIMENTO SUI RISULTATI ONCOLOGICI E FUNZIONAL

No Time to Die: How Kidney Cancer Evades Cell Death

The understanding of the pathogenesis of renal cell carcinoma led to the development of targeted therapies, which dramatically changed the overall survival rate. Nonetheless, despite innovative lines of therapy accessible to patients, the prognosis remains severe in most cases. Kidney cancer rarely shows mutations in the genes coding for proteins involved in programmed cell death, including p53. In this paper, we show that the molecular machinery responsible for different forms of cell death, such as apoptosis, ferroptosis, pyroptosis, and necroptosis, which are somehow impaired in kidney cancer to allow cancer cell growth and development, was reactivated by targeted pharmacological intervention. The aim of the present review was to summarize the modality of programmed cell death in the pathogenesis of renal cell carcinoma, showing in vitro and in vivo evidence of their potential role in controlling kidney cancer growth, and highlighting their possible therapeutic value

Prognostic factors of kidney tumors in T3 stage: role of perirenal fat infiltration, renal sinus infiltration and venous thrombosis

none15noneRocca GC;Schiavina R;BRUNOCILLA E.;Garofalo M;Bertaccini A;Concetti S;Saraceni G;Chessa F;Baccos A;Zukerman Z;Pultrone CV;Passaretti G;Rossi MS;Romagnoli D;Martorana GRocca GC;Schiavina R;BRUNOCILLA E.;Garofalo M;Bertaccini A;Concetti S;Saraceni G;Chessa F;Baccos A;Zukerman Z;Pultrone CV;Passaretti G;Rossi MS;Romagnoli D;Martorana

Accuracy of [11C] Choline positron emission tomography/computed tomography in preoperative staging in patients with bladder cancer referred to radical cystectomy (RC): comparison with conventional computed tomography (CT)

.Accuracy of [11C] Choline positron emission tomography/computed tomography in preoperative staging in patients with bladder cancer referred to radical cystectomy (RC): comparison with conventional computed tomography (CT)