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- 저자 : Ilaria Lucca (검색결과 2 건)
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Arnas Rakauskas,Thomas Tawadros,Ilaria Lucca,Fernanda Herrera,Jean Bourhis,Rodolfo Burruni,Maria Natal Gomes,Caroline Codeluppi,Laura Jolliet,Stefano La Rosa,Jean-Yves Meuwly,Patrice Jichlinski,Domini 대한비뇨의학회 2021 Investigative and Clinical Urology Vol.62 No.4
Purpose: To compare the clinical outcome of males with low-risk and favorable intermediate-risk prostate cancer managed within a standardized modern protocol of active surveillance. Materials and Methods: This was a prospective cohort study with strict and expanded active surveillance criteria in males with prostate cancer. Baseline assessment included multiparametric magnetic resonance imaging (mpMRI), extended systematic biopsy, and software-based MR-targeted biopsy. Follow-up included biannual prostate-specific antigen (PSA) check, mpMRI, and control biopsy once a year for the first 2 years, and afterward mpMRI every 2 years with additional tests as clinically indicated. The primary outcome was the transition rate to active treatment. Results: A total of 51 patients were included: 17 (33%) and 34 (67%) followed protocols of strict (study arm 1) and expanded (study arm 2) active surveillance criteria, respectively. Median age and PSA were 65 years (IQR, 60–69 years) and 5.3 ng/mL (IQR, 4.5–7.7 ng/mL), respectively. At baseline, a median of 2 (IQR, 1–3) cores were positive out of 13 (IQR, 12–14) cores; 22 males (43%) had visible mpMRI lesions. Eight males (24%) in study arm 2 had Gleason score 3+4. After a median follow-up of 36 months (IQR, 24–48 mo), no patient in study arm 1 compared with 17 patients (33%) in arm 2 underwent active treatment (p<0.0005). Conclusions: Although expanding eligibility criteria leads to a greater transition rate to active treatment, active surveillance should be contemplated in well-selected males with favorable intermediate-risk prostate cancer as the curability window seems to be maintained.
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Sebastian L. Hofbauer,Michela de Martino,Christoph Seemann,Nura Zamani,Ilaria Lucca,Andrea Haitel,Shahrokh F. Shariat,Tobias Klatte 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.8
Purpose: To evaluate the impact of presenting symptoms on survival in a contemporaryseries of patients with renal cell carcinoma (RCC). Materials and Methods: We prospectively recorded data on the presenting symptoms,pathology, and RCC-specific survival of 633 consecutive RCC patients who underwentsurgery between 2003 and 2012. Results: Four hundred thirty-three RCCs (68%) were incidental, 111 (18%) were associatedwith local symptoms, and 89 (14%) were associated with systemic symptoms. Among those with incidental RCC, 317 patients (73%) were completely asymptomaticand 116 patients (27%) presented with symptoms not related to the tumor. During amedian follow-up interval of 40 months (interquartile range: 39 to 69 months), 77 patientsdied from RCC. In univariate analyses, symptom classification was significantlyassociated with RCC-specific survival (p<0.001). Patients with incidental RCC andunrelated symptoms tended to have worse prognosis than did patients who were completelyasymptomatic, although this difference was not statistically significant(p=0.057). The symptom classification was associated with advanced TNM stages (p<0.001) and grade (p<0.001). Conclusions: This study confirms that presenting symptoms are associated with tumorcharacteristics and survival. The majority of RCCs are diagnosed incidentally in patientswithout any symptoms or with symptoms not related to RCC. Patients in the lattergroup tend to have a worse prognosis than do patients who are completelyasymptomatic. With the increasing number of incidentally diagnosed RCCs, substratificationof patients with incidental tumors may be prognostically relevant.
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