Mariangela Mancini - Academia.edu (original) (raw)

Papers by Mariangela Mancini

European Journal of Surgical Oncology, 2021

BACKGROUND European Reference Network (ERN) eUROGEN is a cross-border collaboration set up by the... more BACKGROUND European Reference Network (ERN) eUROGEN is a cross-border collaboration set up by the European Commission in 2017 aimed at tackling rare urogenital conditions, including cancers. OBJECTIVE This report aims to assess ERN eUROGEN's operational activity with a focus on rare urogenital cancers. DESIGN, SETTING AND PARTICIPANTS Data for descriptive analyses were collected retrospectively between 2013 and 2017, and prospectively between 2018 and 2020. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Operational indicators were set by the European Commission from 2018. Additionally, in 2019/20 centres self-assessed clinical service provision and provided clinical metrics for rare cancer specialist centres as established by experts. RESULTS AND LIMITATIONS Results revealed that the cumulative rare urogenital cancer population increased 519.8% from 1,631 in 2013 to 10,109 in 2020. This may provide opportunities for research and creation of a large cancer registry. In total, ten centres met the clinical requirements for rare cancer specialist centres providing evidence of high-volume. Differences in data collection methods between centres limit further analyses. Other rare cancer data identified 39 panel discussions, three webinars, and eight publications. CONCLUSIONS Whilst limitations to data analysis remain, ERN eUROGEN has demonstrated excellent operational performance with promising opportunities for rare cancer research.

Current Oncology, 2021

Uretero-enteric anastomotic strictures (UES) after robot-assisted radical cystectomy (RARC) repre... more Uretero-enteric anastomotic strictures (UES) after robot-assisted radical cystectomy (RARC) represent the main cause of post-operative renal dysfunction. The gold standard for treatment of UES is open uretero-ileal reimplantation (UIR), which is often a challenging and complex procedure associated with significant morbidity. We report a challenging case of long severe bilateral UES (5 cm on the left side, 3 cm on the right side) after RARC in a 55 years old male patient who was previously treated in another institution and who came to our attention with kidney dysfunction and bilateral ureteral stents from the previous two years. Difficult multiple ureteral stent placement and substitutions had been previously performed in another hospital, with resulting urinary leakage. An open surgical procedure via an anterior transperitoneal approach was performed at our hospital, which took 10 h to complete, given the massive intestinal and periureteral adhesions, which required very meticulou...

Journal of Endourology Case Reports, 2020

Background: Trocar-site hernias (TSHs) are an uncommon but potentially severe complication of rob... more Background: Trocar-site hernias (TSHs) are an uncommon but potentially severe complication of robotassisted urologic surgery, with an incidence of incarcerated hernias varying from 0.4% to 0.66%. Currently, there are no standardized guidelines on trocar site fascial closure. Although it is widely recommended to close the midline 12-mm port site, there is no agreement on the need for fascial closure of lateral port sites, especially if £12 mm. Cases Presentation: We report three cases of incarcerated intestinal TSHs in the past 10 years in our institution. All were from lateral abdominal ports (two 12 and one 8 mm), after robot-assisted radical prostatectomy. Patients were Caucasian and from 60 to 71 years; symptoms varied widely from obstinate hiccups, abdominal distention with fever, to acute abdomen. In all cases reduction of the herniated loop from the outside, using a minilaparotomy over the port site, was safe and effective. However, in one case bowel resection for bowel ischemic necrosis was necessary. No specific clinical risk factors could be identified in our cases. Conclusion: Incarcerated TSH after robotic urologic surgery may arise from any trocar site, regardless of size and location. This could be treated effectively with a minilaparotomy over the trocar site, to avoid more serious life-threatening consequences such as bowel necrosis and perforation. No risk factor seems to be predictive of TSHs.

Urologia Journal, 2019

Men are at a higher risk of developing bladder cancer, but women present with more advanced disea... more Men are at a higher risk of developing bladder cancer, but women present with more advanced disease and have more unfavourable outcomes. Although epidemiologic and genetical studies have underlined the multifactorial aetiology and gender-related differences of bladder cancer, there is lack of evidence-based recommendation for gender-specific management of bladder cancer. We summarize the evidence and most recent findings on gender-specific differences in bladder cancer incidence, diagnosis, treatment and outcome, spotlighting the gender disparities in genetic and hormonal risk factors, pelvic anatomy, diagnostic setting and surgical choices. We reviewed the literature published on PubMed between 1981 and 2018. Males have a threefold to fourfold higher risk of bladder cancer as compared to females; however, women have higher stage-for-stage mortality, being diagnosed with more advanced disease, mostly due to a delay in haematuria evaluation. Numerous studies indicate an increased ris...

European Urology Supplements, 2006

The extract of Serenoa repens has been shown to be selective for the prostate, with no detectable... more The extract of Serenoa repens has been shown to be selective for the prostate, with no detectable effect on other cellular compartments. This has limited the clinical use of this drug to prostatic diseases. We have investigated the effect of Serenoa repens on two human prostate cancer cell lines PC-3 and LNCap and comparatively on three non prostatic lines, the breast cancer cell line MCF7, the bladder cancer line T24 and the cervix cancer line HeLa, in order to verify the selectively and specificity of the action of this drug. MATERIAL & METHODS: The cell lines were treated with Serenoa repens extract at 100 mg/ml or DMSO vehicle, and examined for cell growth and viability at 4, 24 and 48 hours. Morphologic changes were evaluated by light microscopy (LM) and the flow cytometry (FC) parameters Forward Scatter High (FL-H) for cell size and Side Scatter High (SS-H) for cellular complexity. Cell viability was assessed by trypan blue exclusion. Apoptosis was evaluated by LM and FC using propidium iodide (PI) staining RESULTS: After drug exposure, PC-3 and LNCap cells show dramatic morphological changes by LM: they condense, round up and detach from the plate. At 4 hours the cellular size and cytosolic complexity increase of 50% and 40 % respectively in both cell lines, as shown by FC. Both PC-3 and LNCap cells undergo cell cycle arrest and apoptosis, as shown by a detectable apoptotic sub-G1 peak, and become Trypan blu positive within 24 hours of treatment. In contrast, MCF7, T24 and HeLa cells continue to proliferate with treatment, as demonstrated by increase in cell number at 24 and 48 hours, and no decrease in viability by trypan blue exclusion. Surprisingly, the three non prostatic cell lines undergo dramatic morphological changes after treatment with Serenoa repens, such as cytosolic condensation, vacualization and increase in cellular complexity, as shown by LM and FL-H and SS-H measurements. CONCLUSIONS: The different cell lines analyzed showed similar uptake of the drug and cellular morphological changes. However, apoptosis induction was observed restrictively in the PC3 and LNCap cells. Understanding the possible mechanism of escape from apoptosis in the non prostatic cell lines could be relevant to increase the efficacy of Serenoa repens extract treatment and to potentially extend its use in organs characterized by high lipidic metabolism, such as the breast.

Journal of Vascular Surgery Cases, Innovations and Techniques, 2020

Journal of Biological Chemistry, 2002

We have investigated the mitochondrial and cellular effects of the lipoxygenase inhibitor MK886. ... more We have investigated the mitochondrial and cellular effects of the lipoxygenase inhibitor MK886. Low concentrations (1 M) of MK886 selectively sensitized the permeability transition pore (PTP) to opening, whereas higher concentrations of MK886 (10 M) caused depolarization through combination of an ionophoretic effect with inhibition of respiration. MK886 killed prostate cancer PC3 cells only at the higher, toxic concentration (10 M), whereas the lower concentration (1 M) had no major effect on cell survival. However, 1 M MK886 alone demonstrably induced PTP-dependent mitochondrial dysfunction; and it caused cell death through the mitochondrial pathway when it was used in combination with the cyclooxygenase inhibitor, indomethacin, which had no effects per se. Treatment with 1 M MK886 plus indomethacin sensitized cells to killing by exogenous arachidonic acid, which induces PTP opening and cytochrome c release (

Journal of Surgical Case Reports, 2021

Traumatic lesions of male external genitalia are certainly less frequent than the other body site... more Traumatic lesions of male external genitalia are certainly less frequent than the other body sites and in the majority of cases they are caused by work accidents in the metalworking environment or by gunshot wounds. We present a rare case of traumatic degloving lesion of the male external genitalia with avulsion of the left testis caused by an accidental fall from the ladder. Reconstructive surgery was carried out in a single procedure, obtaining an excellent esthetic and functional result.

The Annals of Thoracic Surgery, 2021

AngioVac system (AngioDynamics, Latham, NY) has already been described for treatment of thromboti... more AngioVac system (AngioDynamics, Latham, NY) has already been described for treatment of thrombotic formations concerning the venous district and the tricuspid valve. We describe an innovative application of the Angio-Vac system to treat the inferior vena cava thrombosis associated with renal cell carcinoma. In a high-surgical risk patient, we utilized a micro-invasive and a modified veno-arterial AngioVac circuit to remove the atrial thrombus, ensure a temporary circulatory support during abdominal surgery, and prevent pulmonary embolism.

European Urology Supplements, 2015

Clinical Kidney Journal, 2019

Background Posterior urethral valves (PUV) account for 17% of paediatric end-stage renal disease.... more Background Posterior urethral valves (PUV) account for 17% of paediatric end-stage renal disease. A major issue in the management of PUV is prenatal prediction of postnatal renal function. Fetal ultrasound and fetal urine biochemistry are currently employed for this prediction, but clearly lack precision. We previously developed a fetal urine peptide signature that predicted in utero with high precision postnatal renal function in fetuses with PUV. We describe here the objectives and design of the prospective international multicentre ANTENATAL (multicentre validation of a fetal urine peptidome-based classifier to predict postnatal renal function in posterior urethral valves) study, set up to validate this fetal urine peptide signature. Methods Participants will be PUV pregnancies enrolled from 2017 to 2021 and followed up until 2023 in >30 European centres endorsed and supported by European reference networks for rare urological disorders (ERN eUROGEN) and rare kidney diseases (...

Urologic Oncology: Seminars and Original Investigations, 2021

Objectives: To develop an international consensus on managing penile cancer patients during the C... more Objectives: To develop an international consensus on managing penile cancer patients during the COVID-19 acute waves. A major concern for patients with penile cancer during the coronavirus disease 2019 (COVID-19) pandemic is how the enforced safety measures will affect their disease management. Delays in diagnosis and treatment initiation may have an impact on the extent of the primary lesion as well as the cancer-specific survival because of the development and progression of inguinal lymph node metastases.

Archivio italiano di urologia, andrologia : organo ufficiale [di] Societa italiana di ecografia urologica e nefrologica, 2020

OBJECTIVE The aim of the study was to assess results and quality of life after kidney transplant ... more OBJECTIVE The aim of the study was to assess results and quality of life after kidney transplant in adult patients with previously bladder augmentation or urinary diversion due to significant lower urinary tract dysfunction. MATERIALS AND METHODS This cross-sectional study examines the outcome of 19 renal allografts transplanted in patients with augmented bladder or urinary diversion over a ten years period; moreover we submitted SF36 questionnaire to evaluate quality of life of these patients and compared the results with the general population. RESULT Between January 1, 2005 and 31 December 2015 we performed 19/1093 renal transplantations in patients with abnormal lower urinary tract previously treated with bladder augmentation or bladder recycling. Current post-transplant follow-up was 47 months (range 18-188). No patient developed any episode of acute or chronic rejection. Mean serum creatinine after one year from transplant was 102 umol/L. Overall survival is 94.8% at the end o...

Journal of Urology, 2019

study assessing safety and feasibility in men with localized prostate cancer. METHODS: The study ... more study assessing safety and feasibility in men with localized prostate cancer. METHODS: The study enrolled 30 men with organ-confined prostate cancer ( T2a, PSA 10 ng/ml, Gleason Grade Group 1-2) at 3 centers. TULSA was delivered with mandated 3 mm margins expected to spare 10% viable prostate at the gland periphery. Primary endpoints were safety (adverse events) and feasibility (spatial precision of conformal ablation). Exploratory outcomes included 1y MRI, 1y and 3y 12-core biopsy, and 5y PSA, quality of life, and survival. RESULTS: Adverse events (AE) to 1y included urinary tract infection (10 men Grade 2), acute retention (3 G1; 5 G2), and epididymitis (1 G3), with no rectal injuries. Between 1y and 5y there were no new serious or severe AE. MRI thermometry confirmed spatial ablation precision of 1.3 mm, covering the targeted 90% of the gland. By 1y, PSA decreased 90% from 5.8 (3.8-8.0) to nadir of 0.6 (0.3-0.8) ng/ml, with 88% (83-95%) prostate volume reduction. Biopsy at 1y ide...

World Journal of Urology

Purpose To assess long-term renal function and micturition pattern of males submitted to transure... more Purpose To assess long-term renal function and micturition pattern of males submitted to transurethral resection of the prostate (TURP) for moderate-to-severe lower urinary tract symptoms (LUTS) after renal transplantation (RT). To investigate the role of clinical and urodynamic (UD) parameters for bladder outlet obstruction (BOO) diagnosis in these patients. Methods Retrospective data analysis of ≥ 50 years old patients who underwent RT between 01/2005 and 12/2016. Patients with moderate-to-severe LUTS after RT who underwent a urologic evaluation and a UD study were included. TURP was performed in case of BOO diagnosis. Kidney function and micturition patterns were evaluated before, 3, 12, 24, 36, and 48 months after TURP. Predictors of BOO were assessed at univariable and multivariable logistic regression models. Statistical analysis was performed with STATA16. Results 233 male patients ≥ 50 years underwent RT. 71/233 (30%) patients developed voiding LUTS. 52/71 (73%) patients wit...