Giario Conti - Academia.edu (original) (raw)
Papers by Giario Conti
Diagnostic Pathology, 2016
When treating bladder cancer patients, the most significant problems usually concern cases with h... more When treating bladder cancer patients, the most significant problems usually concern cases with high-grade non-muscle-invasive carcinoma, and a better understanding of which patients would benefit from early radical cystectomy is urgently needed. The uropathology community is seeking more user-friendly approaches to distinguishing between T1 cancers exhibiting different types of clinical behavior. After a retrospective review, we selected a group of 314 patients who underwent transurethral resection of the bladder (TURB) and were diagnosed with high-grade urothelial carcinoma staged as T1. Three different substaging systems were applied: one was the anatomy-based T1 a/b; and two involved micrometric thresholds of either 0.5 mm of invasion (as proposed by van Rhijn et al.), or 1 mm of invasion (as proposed in the present study). Early reTUR (repeated transurethral resection) was performed in 250 patients, and the same substaging approaches were applied to cases of T1. It proved feasible to apply the 1 mm substaging system in 100 % of cases, the van Rhijn system in 100 %, and the anatomy-based method (T1 a/b) in 72.3 % of cases. At a mean follow-up of 46 months, the recurrence-free survival rate was significantly better (p < 0.001) in the group that underwent reTUR, while none of the three substaging systems reliably predicted recurrences. The 1 mm did seem promising, however, as a threshold for predicting progression, reaching statistical significance in the Kaplan Meier estimates (p < 0.04). Our study shows that micrometric substaging is feasible in this setting and should be extended to include any early reTUR to complete the substaging done after the first TURB. It can also provide helpful prognostic information.
European Urology Supplements, 2015
The Journal of Urology, 2015
Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia, 2012
Men affected with Benign Prostate Hyperplasia (BPH) and Lower Urinary Tract Symptoms (LUTS) are d... more Men affected with Benign Prostate Hyperplasia (BPH) and Lower Urinary Tract Symptoms (LUTS) are demonstrating to require an increasing amount of attention from Urologists and Primary-care Physicians. Over the years, common urological medications were based on either alpha-blockers and/or 5alpha-reductase inhibitors. During the last decade the phytotherapeutic drugs are gaining a more often central role in the BPH and LUTS managements. In particular, clinical usage of the extract of the dried ripe fruit of serenoa repens with a dosage of 320 mg per day, has shown its clinical efficacy and its superiority. Purpose of this multicentric observational retrospective study was to evaluate all the urological aspects (clinical, biochemical, instrumental and pathological) of patients affected by BPH and LUTS, with a PSA < 10 ng/ml, a previous negative prostatic biopsy and in therapy with a daily dose of 320/640 mg of serenoa repens. The study was conducted in 8 different centers throughout...
Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia, 2008
The aim of the present study is to describe the research protocol and preliminary results of an o... more The aim of the present study is to describe the research protocol and preliminary results of an observational survey on presentation patterns of prostate cancer metastasis to bone (METAURO), involving urology departments in several Italian hospitals. The study design was observational and inclusion criteria required subjects with prostate cancer patients who were first diagnosed with metastatic bone disease not more than 18 months before. For each patient recruited to the study, a retrospective evaluation and a prospective surveillance were undertaken. One hundred and ninety-nine patients were enrolled at 32 urological centers in Italy. The median age of participants at first visit was 72.7 years (SD = 7.8). Mean PSA at onset was 323.6 (SD = 1058.3) and these values strongly correlated with Gleason score (Spearman r = 0.228; p = 0.003). The main cause for suspicion of bone metastasis was routine follow up (53%), followed by pathological fracture (31%). Main metastasis sites were loc...
The Journal of Urology, 2015
Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia, 2006
The treatment of choice for superficial bladder TCC is endoscopic resection, followed or not by i... more The treatment of choice for superficial bladder TCC is endoscopic resection, followed or not by intravesical immuno/chemotherapy. Some patients are not responders to common intravesical therapy and are more exposed to disease progression. In this case the suitable treatment is radical cystectomy. Because gemcitabine is effective against advanced bladder cancer, we have initiated a study to evaluate the efficacy of its intravesical use to prevent relapse and disease progression, and tolerance and safety of this drug in patients with multi-treated bladders. In this preliminary study, we cite only data on tolerance. 64 patients were selected, and 61 were evaluable (age range 39-84 years), with multiple-recurrent bladder TCC. All patients were previously treated with intravesical chemotherapy and/or immunotherapy. The protocol provided for intravesical instillation of gemcitabine (2000 mg) once per week for 8 weeks. We collected data regarding problems noted by the patients (both local ...
European Urology Supplements, 2013
European Urology Supplements, 2009
European Urology Supplements, 2009
European Urology Supplements, 2010
European Urology Supplements, 2010
Oncology, 2008
Abnormal epidermal growth factor receptor expression and pre-clinical data prompted us to investi... more Abnormal epidermal growth factor receptor expression and pre-clinical data prompted us to investigate the activity of gefitinib, a selective epidermal growth factor receptor tyrosine kinase inhibitor, in hormone-refractory prostate cancer. Eighty-two patients were randomly assigned to receive prednisone plus gefitinib (pG; n = 44) or prednisone plus placebo (ppl; n = 38). On progression, patients initially assigned to placebo were offered the possibility to receive gefitinib. Best prostate-specific antigen response was the primary endpoint. At a median follow-up time of 29.0 months (26.0-32.0), 77 patients progressed and 51 died. Prostate-specific antigen response was recorded in 6/38 (15.8%; 95% CI 4.2-27.4) and in 5/44 (11.4%; 95% CI 2.0-20.8) patients in pG and ppl groups, respectively. There was no difference between groups in time to progression (median pG 4.0 months, range 3.5-4.5; median ppl 4.5 months, range 3.5-5.0) and survival (median pG 26.5 months, range 16.0-37.0; median ppl 20.5 months, range 14.0-27.0). Adverse events occurred in 19 patients in each arm and were generally mild. pG showed a good tolerability profile but only a limited therapeutic activity in hormone-refractory prostate cancer.
The Journal of Urology, 2010
METHODS: This study includes 156 patients with clinical T1/T2 prostate cancer treated with transp... more METHODS: This study includes 156 patients with clinical T1/T2 prostate cancer treated with transperineal interstitial brachytherapy with I-125 as monotherapy, who had not been treated with an alphablocker for LUTS before brachytherapy, The incidence of alpha-blocker dependency for more than one month for LUTS following brachytherapy was evaluated, and multiple clinical parameters including international prostate symptom score (IPSS) and urodynamic findings were evaluated to identify the factors associated with alpha-blocker dependency on univariate and multivariate analyses.
The Journal of Urology, 2010
The Journal of Urology, 2014
The Journal of Urology, 2009
The Journal of Urology, 2009
The Journal of Urology, 2009
Diagnostic Pathology, 2016
When treating bladder cancer patients, the most significant problems usually concern cases with h... more When treating bladder cancer patients, the most significant problems usually concern cases with high-grade non-muscle-invasive carcinoma, and a better understanding of which patients would benefit from early radical cystectomy is urgently needed. The uropathology community is seeking more user-friendly approaches to distinguishing between T1 cancers exhibiting different types of clinical behavior. After a retrospective review, we selected a group of 314 patients who underwent transurethral resection of the bladder (TURB) and were diagnosed with high-grade urothelial carcinoma staged as T1. Three different substaging systems were applied: one was the anatomy-based T1 a/b; and two involved micrometric thresholds of either 0.5 mm of invasion (as proposed by van Rhijn et al.), or 1 mm of invasion (as proposed in the present study). Early reTUR (repeated transurethral resection) was performed in 250 patients, and the same substaging approaches were applied to cases of T1. It proved feasible to apply the 1 mm substaging system in 100 % of cases, the van Rhijn system in 100 %, and the anatomy-based method (T1 a/b) in 72.3 % of cases. At a mean follow-up of 46 months, the recurrence-free survival rate was significantly better (p &amp;amp;amp;amp;amp;lt; 0.001) in the group that underwent reTUR, while none of the three substaging systems reliably predicted recurrences. The 1 mm did seem promising, however, as a threshold for predicting progression, reaching statistical significance in the Kaplan Meier estimates (p &amp;amp;amp;amp;amp;lt; 0.04). Our study shows that micrometric substaging is feasible in this setting and should be extended to include any early reTUR to complete the substaging done after the first TURB. It can also provide helpful prognostic information.
European Urology Supplements, 2015
The Journal of Urology, 2015
Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia, 2012
Men affected with Benign Prostate Hyperplasia (BPH) and Lower Urinary Tract Symptoms (LUTS) are d... more Men affected with Benign Prostate Hyperplasia (BPH) and Lower Urinary Tract Symptoms (LUTS) are demonstrating to require an increasing amount of attention from Urologists and Primary-care Physicians. Over the years, common urological medications were based on either alpha-blockers and/or 5alpha-reductase inhibitors. During the last decade the phytotherapeutic drugs are gaining a more often central role in the BPH and LUTS managements. In particular, clinical usage of the extract of the dried ripe fruit of serenoa repens with a dosage of 320 mg per day, has shown its clinical efficacy and its superiority. Purpose of this multicentric observational retrospective study was to evaluate all the urological aspects (clinical, biochemical, instrumental and pathological) of patients affected by BPH and LUTS, with a PSA < 10 ng/ml, a previous negative prostatic biopsy and in therapy with a daily dose of 320/640 mg of serenoa repens. The study was conducted in 8 different centers throughout...
Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia, 2008
The aim of the present study is to describe the research protocol and preliminary results of an o... more The aim of the present study is to describe the research protocol and preliminary results of an observational survey on presentation patterns of prostate cancer metastasis to bone (METAURO), involving urology departments in several Italian hospitals. The study design was observational and inclusion criteria required subjects with prostate cancer patients who were first diagnosed with metastatic bone disease not more than 18 months before. For each patient recruited to the study, a retrospective evaluation and a prospective surveillance were undertaken. One hundred and ninety-nine patients were enrolled at 32 urological centers in Italy. The median age of participants at first visit was 72.7 years (SD = 7.8). Mean PSA at onset was 323.6 (SD = 1058.3) and these values strongly correlated with Gleason score (Spearman r = 0.228; p = 0.003). The main cause for suspicion of bone metastasis was routine follow up (53%), followed by pathological fracture (31%). Main metastasis sites were loc...
The Journal of Urology, 2015
Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia, 2006
The treatment of choice for superficial bladder TCC is endoscopic resection, followed or not by i... more The treatment of choice for superficial bladder TCC is endoscopic resection, followed or not by intravesical immuno/chemotherapy. Some patients are not responders to common intravesical therapy and are more exposed to disease progression. In this case the suitable treatment is radical cystectomy. Because gemcitabine is effective against advanced bladder cancer, we have initiated a study to evaluate the efficacy of its intravesical use to prevent relapse and disease progression, and tolerance and safety of this drug in patients with multi-treated bladders. In this preliminary study, we cite only data on tolerance. 64 patients were selected, and 61 were evaluable (age range 39-84 years), with multiple-recurrent bladder TCC. All patients were previously treated with intravesical chemotherapy and/or immunotherapy. The protocol provided for intravesical instillation of gemcitabine (2000 mg) once per week for 8 weeks. We collected data regarding problems noted by the patients (both local ...
European Urology Supplements, 2013
European Urology Supplements, 2009
European Urology Supplements, 2009
European Urology Supplements, 2010
European Urology Supplements, 2010
Oncology, 2008
Abnormal epidermal growth factor receptor expression and pre-clinical data prompted us to investi... more Abnormal epidermal growth factor receptor expression and pre-clinical data prompted us to investigate the activity of gefitinib, a selective epidermal growth factor receptor tyrosine kinase inhibitor, in hormone-refractory prostate cancer. Eighty-two patients were randomly assigned to receive prednisone plus gefitinib (pG; n = 44) or prednisone plus placebo (ppl; n = 38). On progression, patients initially assigned to placebo were offered the possibility to receive gefitinib. Best prostate-specific antigen response was the primary endpoint. At a median follow-up time of 29.0 months (26.0-32.0), 77 patients progressed and 51 died. Prostate-specific antigen response was recorded in 6/38 (15.8%; 95% CI 4.2-27.4) and in 5/44 (11.4%; 95% CI 2.0-20.8) patients in pG and ppl groups, respectively. There was no difference between groups in time to progression (median pG 4.0 months, range 3.5-4.5; median ppl 4.5 months, range 3.5-5.0) and survival (median pG 26.5 months, range 16.0-37.0; median ppl 20.5 months, range 14.0-27.0). Adverse events occurred in 19 patients in each arm and were generally mild. pG showed a good tolerability profile but only a limited therapeutic activity in hormone-refractory prostate cancer.
The Journal of Urology, 2010
METHODS: This study includes 156 patients with clinical T1/T2 prostate cancer treated with transp... more METHODS: This study includes 156 patients with clinical T1/T2 prostate cancer treated with transperineal interstitial brachytherapy with I-125 as monotherapy, who had not been treated with an alphablocker for LUTS before brachytherapy, The incidence of alpha-blocker dependency for more than one month for LUTS following brachytherapy was evaluated, and multiple clinical parameters including international prostate symptom score (IPSS) and urodynamic findings were evaluated to identify the factors associated with alpha-blocker dependency on univariate and multivariate analyses.
The Journal of Urology, 2010
The Journal of Urology, 2014
The Journal of Urology, 2009
The Journal of Urology, 2009
The Journal of Urology, 2009