1.The Impact of Neoadjuvant Chemotherapy on Cancer Specific Mortality in Patients With Upper Tract Urothelial Carcinoma: A Retrospective Analysis of an Other Cause Mortality Risk Matched Cohort
Alessandro BERTINI ; Alex STEPHENS ; Alessio FINOCCHIARO ; Silvia VIGANÒ ; Elnza GUIVATCHIAN ; Antonio PERRI ; Giovanni LUGHEZZANI ; Nicolò BUFFI ; Gabriele SORCE ; Vincenzo FICARRA ; Alberto BRIGANTI ; Andrea SALONIA ; Francesco MONTORSI ; Riccardo AUTORINO ; Craig ROGERS ; Firas ABDOLLAH
Journal of Urologic Oncology 2025;23(2):188-197
Purpose:
Although neoadjuvant chemotherapy (NAC) may benefit upper tract urothelial carcinoma (UTUC) treatment, most studies are retrospective and affected by selection bias, as healthier patients are more likely to receive NAC. We therefore aimed to investigate NAC’s impact on cancer specific mortality (CSM) in an other-cause mortality (OCM) matched cohort
Methods:
The Surveillance, Epidemiology, and End Results database was queried to identify patients with histological diagnosis of UTUC (pT1-4N0-3M0) at radical nephoureterectomy (RNU) between 2007–2021. Patients who underwent systemic therapy before RNU were classified as having received NAC. Cox regression was used to calculate the 5 year-OCM risk, which was used to construct a 1:3 propensity-score matched cohort. Then, in the matched cohort, we performed competing risk regression analysis to investigate the impact of NAC on CSM.
Results:
We included 4,936 patients, 388 (7.9%) of whom underwent NAC. Median (interquartile range) age at diagnosis was 72 (64–79) years. The 5-year OCM rate was 26.4% versus 37.1% (p=0.004) in patients who received NAC men versus in those who did not receive NAC, but that difference became not statistically significant after matching (p=0.9). The standardized mean difference was 0.0003 for OCM risk, indicating a good match. In the matched cohort, patients in the NAC-group were more likely to be younger (67 vs. 73, p<0.0001), to be diagnosed more recently (2018 vs. 2015, p<0.0001) and to have a pN+UTUC (28.8% vs. 12.3%, p<0.0001), compared to no-NAC group. At MVA analysis, patients who did not undergo NAC had a significantly higher CSM-risk (hazard ratio,1.78; 95% confidence interval, 1.27–2.51; p<0.01), than their counterpart who received NAC.
Conclusion
Compared to patients who did not receive NAC, those who received NAC seems to have a reduced CSM-risk for UTUC, when matched with their calculated OCM-risk. However, to establish it as the optimal treatment strategy for UTUC, additional prospective randomized studies are needed.
2.Orthodontic treatment of a transposed maxillary canine and first premolar in a young patient with Class III malocclusion.
Antonio GRACCO ; Laura SIVIERO ; Alessandro PERRI ; Lorenzo FAVERO ; Edoardo STELLINI
The Korean Journal of Orthodontics 2015;45(6):322-333
A 12-year-old girl was referred to our clinic for evaluation of an unaesthetic dental appearance. All permanent teeth were erupted, while the deciduous maxillary right canine was retained. Cone-beam computed tomography revealed a complete transposition of the maxillary left canine and first premolar involving both the crowns and the roots. Initial cephalometric analysis showed a skeletal Class III pattern, with a slight maxillary retrusion and a compensated proclination of the upper incisors. The patient's teeth were considered to be in the correct position; therefore, we decided to attempt treatment by correcting the transposition and using only orthodontic compensation of the skeletal Class III malocclusion. After 25 months of active orthodontic treatment, the patient had a Class I molar and canine relationship on both sides, with ideal overbite and overjet values. Her profile was improved, her lips were competent, and cephalometric evaluation showed acceptable maxillary and mandibular incisor inclinations. The final panoramic radiograph showed that good root parallelism was achieved. Two-year follow-up intraoral photography showed stable results.
Bicuspid*
;
Child
;
Compensation and Redress
;
Cone-Beam Computed Tomography
;
Crowns
;
Female
;
Follow-Up Studies
;
Humans
;
Incisor
;
Lip
;
Malocclusion*
;
Molar
;
Overbite
;
Photography, Dental
;
Retrognathia
;
Tooth
3.Multidisciplinary correction of anterior open bite relapse and upper airway obstruction.
Antonio GRACCO ; Alessandro PERRI ; Laura SIVIERO ; Giulio Alessandri BONETTI ; Francesco COCILOVO ; Edoardo STELLINI
The Korean Journal of Orthodontics 2015;45(1):47-56
A 27-year-old man presented an anterior open bite relapse. He had low tongue posture positioned anteriorly at rest and during swallowing and reported chronic difficulty in nose breathing. Head cone-beam computed tomography revealed nasal septum deviation, right turbinate hypertrophy, and left maxillary sinus congestion, which were thought to contribute to the breathing problem, encourage the improper tongue posture, and thereby cause the relapse. Multidisciplinary treatment involving an otorhinolaryngologist, an orthodontist, and a periodontist resolved the upper airway obstruction and corrected the malocclusion. The follow-up examination after 3 years 5 months demonstrated stable results.
Adult
;
Airway Obstruction*
;
Cone-Beam Computed Tomography
;
Deglutition
;
Estrogens, Conjugated (USP)
;
Follow-Up Studies
;
Head
;
Humans
;
Hypertrophy
;
Malocclusion
;
Maxillary Sinus
;
Nasal Septum
;
Nose
;
Open Bite*
;
Posture
;
Recurrence*
;
Respiration
;
Tongue
;
Turbinates

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