rome and Prostatic-Neoplasms

Laparoscopic prostatectomy (LRP) may activate clotting system influencing the risk of perioperative thrombosis in patients with prostate cancer. Moreover, different anaesthetic techniques can also modify coagulant factors. Thus, the aim of this study was to investigate the effects on pro- and anti-coagulant and fibrinolytic factors of two established types of anaesthesia in patients with prostate cancer undergoing elective LRP.. 102 patients with primary prostate cancer, who underwent conventional LRP or robot-assisted laparoscopic prostatectomy (RALP), were studied and divided into 2 groups to receive total intravenous anesthesia with target-controlled infusion (TIVA-TCI) or balanced inhalation anaesthesia (BAL) prior to surgery. Before the induction of anaesthesia (T0), 1 hr (T1) and 24 hrs post-surgery (T2), some pro-coagulant factors, fibronolysis markers, p-selectin and haemostatic system inhibitors were evaluated.. Both TIVA-TCI and BAL patients showed a marked and significant increase in pro-coagulant factors and consequent reduction in haemostatic system inhibitors in the early post operative period (p ≤ 0.004 for each markers). Use of RALP showed a significant increase in prothrombotic markers as compared to LRP. In TIVA patients undergoing LRP, a significant reduction of p-selectin levels between T0 and T2 (p = 0.001) was observed as compared to BAL, suggesting a better protective effect on platelet activation of anaesthetic agents used for TIVA.. Both anaesthetic techniques significantly seem to increase the risk of thrombosis in prostate cancer patients undergoing LRP, mainly when the robotic device was utilized, encouraging the use of a peri-operative thromboembolic prophylaxis in these patients.

Topics: Aged; Anesthesia, Inhalation; Anesthesia, Intravenous; Blood Coagulation Factors; Blood Coagulation Tests; Hemostasis; Humans; Laparoscopy; Male; Middle Aged; Prostatectomy; Prostatic Neoplasms; Risk Factors; Robotic Surgical Procedures; Rome; Thrombosis; Time Factors; Treatment Outcome

To evaluate sample quality, prostate cancer detection rate and biopsy morbidity in transrectal ultrasound (TRUS)-guided prostate biopsy (PBx) using 16- or 18-gauge Tru-Cut needles.. Patients undergoing TRUS PBx were consecutively randomized with a 1:1 ratio into two study arms: group A (16-gauge needle) and group B (18-gauge needle). Core fragmentation and small specimen length (<10 mm) rate were the sample quality criteria. Three consecutive visual analog scale tests for pain and the Clavien surgical classification complications grading for rectal bleeding were used to evaluate TRUS PBx morbidity.. Overall, 250 patients were evaluated. No statistically significant difference between 16- and 18-gauge biopsy needles was recorded for cancer detection rate (29.6 vs. 30.4%, p = 0.890), core fragmentation rate (5 vs. 7%, p = 0.425) and shorter specimen (2 vs. 2%, p = 0.309). Pain control was similar in the two groups during the biopsy, 30 min after biopsy and the evening of the same day. Very small or absent bleeding was the more frequent complication observed in each group.. Prostate detection rate and sample quality were not influenced by needle size. A 16-gauge needle biopsy does not increase TRUS PBx morbidity.

Topics: Adult; Aged; Aged, 80 and over; Biopsy, Needle; Chi-Square Distribution; Equipment Design; Gastrointestinal Hemorrhage; Humans; Male; Middle Aged; Needles; Nerve Block; Pain; Predictive Value of Tests; Prospective Studies; Prostate; Prostatic Neoplasms; Rectal Diseases; Rome; Single-Blind Method; Ultrasonography, Interventional

Because of the lack of conclusive and well-conducted randomized studies, the optimal therapy for prostate tumors remains controversial. The aim of this study was to retrospectively compare the results of radical surgery vs. a conservative approach such as external beam radiotherapy (EBRT) plus androgen deprivation therapy using an intent-to-treat analysis on two pretreatment defined, concurrently treated, high-risk patient populations.. Between January 2003 and December 2007, 162 patients with high-risk prostate cancer underwent an EBRT plus androgen deprivation therapy program at the RT department of our institute. In the same period, 122 patients with the same high-risk disease underwent radical prostatectomy (RP) at the urologic department of our institute. Patients with adverse pathologic factors also underwent adjuvant EBRT with or without androgen deprivation therapy. The primary endpoint was freedom from biochemical failure.. The two groups of high-risk patients were homogeneous in terms of freedom from biochemical failure on the basis of the clinical T stage, biopsy Gleason score, and initial prostate-specific antigen level. The median follow-up was 38.6 and 33.8 months in the EBRT and RP groups, respectively. The actuarial analysis of the freedom from biochemical failure showed a 3-year rate of 86.8% and 69.8% in the EBRT and RP group, respectively (p = .001). Multivariate analysis of the whole group revealed the initial prostate-specific antigen level and treatment type (EBRT vs. RP) as significant covariates.. This retrospective intention-to-treat analysis showed a significantly better outcome after EBRT than after RP in patients with high-risk prostate cancer, although a well-conducted randomized comparison would be the best procedure to confirm these results.

Topics: Aged; Androgen Antagonists; Humans; Male; Middle Aged; Neoplasm Staging; Prostate-Specific Antigen; Prostatectomy; Prostatic Neoplasms; Radiotherapy Dosage; Retrospective Studies; Rome; Treatment Outcome

This study describes and discusses a rare case of metastatic carcinoma that affected the skeleton of an adult male recovered in the necropolis of Casal Bertone in Rome (Italy). The necropolis, which dates back to the Imperial Age (1st to 2nd century AD), is located near some residential structures and a large place identified as a fullery (fullonica).. Anthropological and paleopathological studies of the skeletal remains were performed via careful macroscopic, microscopic, radiological (X-ray and CT scan), and histological investigation.. The skeleton displayed mixed osteoclastic and osteoblastic lesions that mainly involved the axial bones, in particular the sternum, the ribs, the spine, and the scapular and pelvic girdles. The anatomical distribution and the destructive and proliferative nature of the lesions suggested diffuse metastases arising from a soft-tissue primary cancer. The age and sex of the individual, as well as radiographic and histological pictures, allowed diagnosis of an advanced prostate cancer with extensively diffused bone metastases.. At present, this is the only case of prostate cancer from the Imperial Age recovered in Rome.

Topics: Body Remains; Bone and Bones; History, Ancient; Humans; Italy; Male; Middle Aged; Paleopathology; Prostate; Prostatic Neoplasms; Rome

Topics: Animals; Congresses as Topic; Finland; Humans; Male; Prostatic Neoplasms; Rome