Alberto Martini

University of Texas MD Anderson Cancer Center | MD Anderson

Background: Decreased functional outcome after partial nephrectomy is associated with overall mortality. Objective: To create a model that predicts ≥25% reduction from baseline estimated glomerular filtration rate (eGFR) in patients undergoing robot-assisted partial nephrectomy (RAPN) and to investigate the role of acute kidney injury (AKI) in t...

Objective to investigate the genomic features of tertiary pattern 5 (TP5) on radical prostatectomy specimens in an effort to explain the poor clinical outcomes associated with this disease subtype. Patients & Methods Data from 159 men with Gleason Grade Group (GGG) 3 or 4 were considered. All patients had Decipher diagnostic testing with transcrip...

Background Achieving a pathologic complete response (pCR) with neoadjuvant chemotherapy (NAC) in patients with muscle‐invasive bladder cancer (MIBC) has been associated with improved overall survival (OS). This study was aimed at evaluating the impact of pathologic downstaging (pDS; ie, a pT stage at least 1 stage lower than the pre‐NAC cT stage) o...

Objective: To describe the natural history of untreated muscle invasive bladder cancer (MIBC) and compare the oncological outcomes of treated and untreated patients. Methods: We utilized a database encompassing all patients with newly-diagnosed bladder cancer in Stockholm, Sweden between 1995-1996. The median follow-up for survivors was 14.4 yrs...

Importance Prostate cancer is the most common malignant neoplasm among men and is the one with the highest positive surgical margin (PSM) rate. This high rate is due to the difficulty in balancing the risk of extraprostatic disease and excising periprostatic structures, which ultimately affects patients’ quality of life. In the case of a PSM, the a...

Background: Prior studies on robot-assisted laparoscopic prostatectomy (RALP) have shown that preservation of the anterior periprostatic structures is associated with good functional outcomes in terms of urinary continence and erectile function. With this in mind, we developed a technique for preservation of the lower part of the detrusor apron (L...

Background: The concordance rates of transperineal (TP) versus transrectal (TR) prostate biopsies with radical prostatectomy (RP) specimen have been assessed poorly in men diagnosed with magnetic resonance imaging (MRI)-targeted biopsy (TBx). Objective: To evaluate International Society of Urological Pathology (ISUP) concordance rates between th...

Introduction: A better definition of the prognostic significance of non-metastatic pT3a stage RCC subcategories is crucial to select the best candidate for adjuvant treatment. The aim of the study is to investigate the differential prognosis of extrarenal involvement in patients with non-metastatic pT3a RCC. Materialsand methods: From a single i...

Purpose The aim of this study was to develop a model to predict high-genomic-risk prostate cancer (PCa) according to Decipher score, a validated 22 gene prognostic panel. By doing so, one might select the individuals who are likely to benefit from genomic testing and improve pre-op counseling about the need for adjuvant treatments. Methods We retr...

Introduction: The urological community's opinion over the management of men being found with pathologically positive nodes (pN+) following radical prostatectomy (RP) performed with curative intent after preoperative negative conventional staging (cN0M0) has never been assessed. This remains crucial, especially considering the advent of novel imagi...

Purpose The aim was to evaluate the prognostic role of sub-categories of ISUP 4 prostate cancer (PCa) on final pathology, and assess the tumor architecture prognostic role for predicting biochemical recurrence (BCR) after radical prostatectomy. Methods From a prospectively-maintained database, we included 370 individuals with ISUP 4 on final patho...

Objectifs L’essai STAMPEDE a rapporté des preuves de niveau 1 en faveur d’une intensification de la thérapie systémique associée à une radiothérapie locale et à une hormonothérapie longue durée comme nouveau standard chez les hommes atteints d’un cancer de la prostate (CaP) à très haut risque, localisé ou localement avancé. L’objectif était d’évalu...

Objectifs La stadification locale du cancer de la prostate (CaP) repose sur le toucher rectal (TR), qui reste donc la norme dans nos recommandations. Cette issue est controversée car l’IRM est désormais l’outil diagnostique le plus influent pour la stadification locale. L’objectif était de comparer plusieurs modèles T basés sur le TR ou l’IRM pour...

Objectifs Proposer une standardisation de la technique chirurgicale robot-assistée intracorporelle d’entérocystoplastie afin de faciliter la transition de la chirurgie ouverte vers le « totally intracorporeal ». Méthodes Il s’agit d’une patiente âgée de 53 ans, aux antécédents de tabagisme et cholécystectomie, hospitalisée pour prise en charge d’u...

Objectifs L’objectif est d’évaluer le rôle pronostic des sous-catégories de cancer de la prostate (CaP) de groupe de grade 4 (GG4) diagnostiqué sur pièce de prostatectomie radicale (PR), et également d’évaluer le rôle pronostic de l’architecture tumorale pour prédire la récidive biochimique après prostatectomie radicale. Méthodes Nous avons analys...

Background Partial nephrectomy (PN) is a challenging procedure, which can be associated with severe complications. In consequence, the search for accurate and independent indicators of unfavorable surgical outcomes appears warranted. We aimed at evaluating the impact of frailty status on surgical, functional and oncologic outcomes in patients under...

Long-term oncologic data on patients undergoing robot-assisted radical cystectomy (RARC) for non-metastatic bladder cancer (BCa) are limited. The purpose of this study is to describe long-term oncologic outcomes of patients receiving robotic radical cystectomy at a high-volume European Institution. We analyzed data of 107 patients treated with RARC...

Recently, the use of targeted biopsy has been subject to critics, as it has been speculated that targeted biopsy might lead to overdiagnosis of clinically significant prostate cancer (PCa). In this study, we tried to evaluate whether targeted sampling in patients with organ-confined disease and ISUP 2 disease was associated with downgrading of the...

Over time, robot-assisted surgery has become more and more common for the removal of the prostate gland. However, owing to the adjacent anatomical location of the prostate to the urethral sphincter complex, radical prostatectomy can be associated with adverse functional outcomes; post-prostatectomy incontinence remains an issue with a highly variab...

Background A prostate-specific antigen density (PSAd) cutoff of 0.15 ng/ml/cc is a commonly recommended threshold to identify patients with negative prostate magnetic resonance imaging (MRI) who should proceed to a prostate biopsy. We were unable to find any study that explicitly examined the properties of this threshold compared with others. Obje...

Background Local staging of prostate cancer (PCa) still relies on digital rectal examination (DRE), which therefore remains the standard for risk stratification in guideline recommendations, clinical trials, and patient counseling. This issue is increasingly controversial as multiparametric magnetic resonance imaging (mpMRI) has become the most inf...

In candidates to robot-assisted radical prostatectomy (RARP) for locally advanced (iT3) prostate cancer on preoperative MRI, the performance of MRI for local staging is demonstrably suboptimal, and currently no prediction tools that might help surgeons in preoperative planning are available. We analyzed data of 685 patients with iT3 prostate cancer...

PurposeThe KEYNOTE-564 trial showed improved disease-free survival (DFS) for patients with high-risk renal cell carcinoma (RCC) receiving adjuvant pembrolizumab as compared to placebo. However, if systematically administered to all high-risk patients, it might lead to the overtreatment in a non-negligible proportion of patient. Therefore, we aimed...

Purpose of review: This review aims to report the latest discoveries regarding the relationship between BMI, obesity, and cancer development and treatment. Recent findings: Obesity and metabolic syndrome relationships with cancer have been deeply investigated in the literature but their association is still debated. Currently, it has been record...

Background With the advent of immuno-oncology compounds in randomized trials, we observe more and more survival curves crossing. From a statistical standpoint this corresponds to violation of the proportional hazard assumption. When this occurs, the hazard ratio from the Cox regression is not reliable as an estimate. Herein, we aimed to identify th...

To test whether body mass index (BMI) amongst patients with metastatic castration-resistant prostate cancer (mCRPC) is associated with overall survival (OS) and cancer-specific survival. Individual patient data from 1577 men with mCRPC treated with docetaxel and prednisone from the control arms of ASCENT2, VENICE, and MAINSAIL were considered. The...

Background: Whether early ligation of the dorsal venous complex (DVC) might improve recovery of urinary continence (UC) after robot-assisted radical prostatectomy (RARP) has never been investigated in a prospective randomized study. Objective: To assess whether early DVC ligation might affect UC recovery after RARP. Intervention: DVC ligation...

Background: Although multiparametric magnetic resonance imaging (MRI) has high sensitivity, its lower specificity leads to a high prevalence of false-positive lesions requiring biopsy. Objective: To develop and externally validate a scoring system for MRI-detected Prostate Imaging Reporting and Data System (PIRADS)/Likert ≥3 lesions containing c...

The treatment of early-stage penile carcinoma is usually represented by wide excision or partial penectomy with or without inguinal lymph node dissection. However, laser ablation of the tumor may have a prominent role as an organ-sparing approach. In this regard, the combination of UltraPulse CO₂ laser and photodynamic therapy (PDT) may...

Introduction Metastatic urothelial cancer (mUC) is an aggressive disease with limited overall survival and treatment options. Antibody-drug conjugates (ADCs) were designed with the intent to deliver potent cytotoxic drugs selectively to antigen-expressing tumor cells by linking cytotoxins to monoclonal antibodies (mAbs) and have emerged as new trea...

The rising costs of cancer care with the introduction of new agents are a challenge. The impact of these costs differs among countries. We compare costs for metastatic prostate cancer, with prices normalized to international dollars, as an example that highlights the need for cost-effectiveness analyses in trials and treatment guidelines.

Background Despite recent advances in the treatments of metastatic castration resistant prostate cancer (mCRPC), patients’ prognosis remains suboptimal and novel treatment combinations are under scrutiny. On this matter, the recent ACIS trial tested the role of abiraterone plus apalutamide (androgen annihilation) in addition to androgen deprivation...

Purpose Metastatic ccRCC has peculiar tropism in the pancreas. We describe the characteristics and pathways of progression of patients with PM in a large multi-institutional consortium and compare them to patients with metastases from ccRCC at other sites. Methods Detailed clinical and histopathological data were collected. To account for differen...

Purpose of review: To evaluate intermediate clinical endpoints that have been proposed as potential surrogates for overall survival amongst patients with locally advanced and metastatic urothelial carcinoma. Recent findings: Several endpoints have been proposed as potential surrogates for overall survival. They are: pathologic downstaging or com...

Background The European Association of Urology guidelines recommend the use of imaging, biomarkers, and risk calculators in men at risk of prostate cancer. Risk predictive calculators that combine multiparametric magnetic resonance imaging with prebiopsy variables aid as an individualized decision-making tool for patients at risk of prostate cancer...

Background The current standard of care of systemic treatment for metastatic hormone sensitive prostate cancer (mHSPC) includes androgen deprivation therapy (ADT) with either docetaxel or advanced androgen blockage (AAB). Recently, two studies have tested the combination of ADT, docetaxel and AAB (triplet therapy) relative to docetaxel and ADT in t...

The recent introduction of immunotherapy in the first line setting of advanced renal cell carcinoma (aRCC) has dramatically improved patients’ prognosis. The aim of the current meta-analysis was to provide level 1a evidence supporting the use of pembrolizumab plus tyrosine kinase inhibitors (TKI) as first-line treatment for advanced RCC. All publis...

Background To date, multidisciplinary team (MDT) evaluation, enrollment in trials evaluating the role of perioperative therapies and deferred active treatments represent accepted strategies for patients with Renal Cell Carcinoma (RCC), which are under investigation to maximize cancer control and implement health care policies and value-based care....

e16536 Background: mUC is an aggressive disease with limited overall survival. Recently, immunotherapy with checkpoint inhibitors (ICI) has dramatically improved outcomes but with limited response rates and overall survival. ADC were designed with the intent to deliver potent cytotoxic drugs selectively to antigen-expressing tumor cells by linking...

Purpose To compare cancer-specific mortality (CSM) and overall mortality (OM) between immediate radical cystectomy (RC) and Bacillus Calmette–Guérin (BCG) immunotherapy for T1 squamous bladder cancer (BCa). Methods We retrospectively analysed 188 T1 high-grade squamous BCa patients treated between 1998 and 2019 at fifteen tertiary referral centres...