Campi, R

Carini, Marco

Chinderni, A

Cocci, A

Fantechi, R

Frizzi, J

Gacci, M

J. a. e. g. e. r., T

Lapini, A

Mari, A

Minervini, Andrea

Serni, Sergio

Vittori, G

English

Florence Research

Introduction: With the introduction of photosensitizing drugsallowing photodynamic diagnostic (PDD) for the bladdercancer, diagnosis has become more accurate. The mainlimitation of the procedure is the false-positive detection rate,which ranges from 12% to 60%. The onset of multifocaltransitional cell carcinoma has been described as a panurothelialdisease as it evolves because of genetic defects that are presentalso in histological negative urothelial tissue. Objective: Weanalyzed chromosomal patterns of false-positive lesions in thePDD and compared them with the findings of random biopsieswith the intent to observe if hexaminolevulinate detectschromosomal aberrations in histological healthy tissue. Patientsand Methods: Included in the study were 18 patient,16 men and2 women, with a mean age of 70.5 (range=47-83) years. All hadfalse-positive PDD confirmed in the histology. A randomsample was taken from all patients. The chromosomal patternsof all samples were analyzed with fluorescence in situhybridization (FISH). Results: From January 2012 untilNovember 2014, a total of 266 bladder biopsies were performedin 30 patients with a positive PDD finding. Eighteen patientshad false-positive biopsies in a total of 40 biopsies. In thesepatients, a total of 25 random biopsies were also performed.Seven out of 18 patients showed chromosomal aberration in 10(25%) of the false-positive biopsies. All 10 biopsies showedaneusomy of the Locus 9p21 (p16), 6 (13%) aneusomy ofchromosome 3 and 5 biopsies (12,5%) aneusomy ofchromosome 7 and chromosome 17. In 4 patients, the FISH ofthe control random biopsy was positive. One had an aneusomyof Locus 9p21 (p16), the other three had anuesomy also forchromosomes 3, 7 and 17. Conclusion: In our trial, over a thirdof the patients with a false-positive PDD finding already expresschromosomal aberrations in these lesions.120SIMPLE ENUCLEATION FOR THE TREATMENTOF HIGHLY COMPLEX RENAL TUMORS:PERIOPERATIVE, FUNCTIONAL AND ONCOLOGICAL RESULTSGianni Vittori, Andrea Mari, Riccardo Campi, Jacopo Frizzi, Tommaso Jaeger, Andrea Chindemi,Riccardo Fantechi, Andrea Cocci, Mauro Gacci, Alberto Lapini, Sergio Serni, Marco Carini and Andrea MinerviniDepartment of Urology, Careggi Hospital, University ofFlorence, Florence, ItalyAim: To assess perioperative, functional and oncologicalresults of simple enucleation (SE) in patients with highlycomplex renal tumors (PADUA score 10-13). Materials andMethods: Data of 510 patients treated with SE for renal cellcarcinoma (RCC) between July 2006 and August 2013 in ourDepartment were gathered in a prospectively maintaineddatabase. Of these, 96 had highly complex renal tumors(PADUA 10-13, Figure 1A) and were selected for this study,including 76 treated open and 20 with robotic SE(endoscopic robotic-assisted simple enucleation (ERASE)).Conventional perioperative variables were collected andcompared between open and robotic approach with univariateanalysis. Survival status and functional data were gatheredat follow-up. The probability of survival was estimated bythe Kaplan-Meier method. Results: Mean (range) clinicaltumor diameter was 4.8 cm (interquartile range (IQR)=3-10).PADUA score was 10, 11, 12 and 13 in 57.3%, 29.2%,11.5% and 2.1% of tumors, respectively. Overall, 19.8% ofANTICANCER RESEARCH 35: 3615-3740 (2015)3694Figure 1. (Abstract 120).patients had stage ≥3 chronic kidney disease (CKD) and17.7% an imperative/relative indication. Clamping of renalpedicle was used for almost all patients (99%) with a meanwarm ischemia time (WIT) of 19.2±5.7 minutes. Meanoperative time was 126 minutes, mean estimated blood loss(EBL) 200 cc and median length of stay (LOS) 6 days(IQR=5-7). Percentage of patients with postoperativecomplications was 26.1% (2.1% Clavien 1, 14.6% Clavien2, 8.3% Clavien 3, 1% Clavien 4). Benign tumors accountedfor 12.5% of patients. Positive surgical margin (PSM) ratewas 3.6% (3/84). The trifecta outcome was accomplished in56.2% of patients. The mean±SD (range) follow-up was54±26 (14-96) months. The 5-year cancer-specific survival(CSS), recurrence-free survival (RFS) and overall survival(OS) rates resulted 96.1%, 90.8% and 88.0%, respectively.Preoperative, 3rd postoperative day, one month postoperativeand follow-up median (IQR) estimated glomerular filtrationrate (eGFR) was 79 (64-97), 68 (51-82), 76 (56-88) and 66(50-81) ml/min/1.73 m2, respectively (Figure 1B).Discussion and Conclusion: The optimal oncological andfunctional results of SE suggest that ERASE is particularlyappropriate to treat highly complex renal masses, minimizingthe loss of healthy renal volume and widening the indicationsof NSS according to the latest European Association ofUrology (EAU) guidelines.122ASAP AND HGPIN PREDICTIVE VALUE OF PROSTATE CANCER DIAGNOSIS: CAN WE IMPROVE IT?Marco Agnello1, Maurizio Barale1, Marco Oderda1, Simone Giona1, Giancarlo Marra1, Lorenzo Daniele2,Donatella Pacchioni2, Luisa Delsedime2, Paola Dalmasso3,Nathalie Nicolaiew4, Alexandre De La Taille5, Bruno Frea1,Hendrik Van Poppel6, Steven Joniau6 and Paolo Gontero1Departments of 1Urology, 2Pathology, and 3Epidemiology,San Giovanni Battista Hospital, Turin, Italy;4Faculty of Medicine, Université Paris-Est Créteil Val DeMarne, Paris, France;5Department of Urology, CHU Mondor, Créteil Val DeMarne, Paris, France;6Department of Urology, University Hospital Gasthuisberg,Leuven, BelgiumIntroduction and Objectives: Operator-dependency and lackof standardized diagnostic criteria may affect ability of highgrade prostatic intraepithelial neoplasia (HGPIN) andatypical small acinar proliferation (ASAP) to predict prostatecancer (PCa). We assessed the long-term predictive ability ofAbstracts of the 25th Annual Meeting of the Italian Society of Uro-Oncology (SIUrO), 21-23 June, 2015, Rome, Italy3695Figure 1. (Abstract 122).

SIMPLE ENUCLEATION FOR THE TREATMENT

OF HIGHLY COMPLEX RENAL TUMORS:

PERIOPERATIVE, FUNCTIONAL

AND ONCOLOGICAL RESULTS

https://flore.unifi.it/retrieve/handle/2158/1061740/203817/120.pdf

SIMPLE ENUCLEATION FOR THE TREATMENT OF HIGHLY COMPLEX RENAL TUMORS: PERIOPERATIVE, FUNCTIONAL AND ONCOLOGICAL RESULTS

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