Humanitas urologists were among the speakers present at the American Urological Association (AUA) annual meeting, held in New Orleans (USA) from May 15th to May 19th. Dr. Massimo Lazzeri and Dr. Nicolò Buffi presented intriguing results based on studies conducted by Prof. Giorgio Guazzoni (Head of Urology) and his team. The study was dedicated to the new markers for early diagnosis of prostate cancer after prostatectomy and active monitoring of patients with bladder cancer. It also focused on the importance of intraoperative examination (known as “frozen section”) for proper diagnosis.


What aspects were presented of the study on new markers?

During the American Urological Association (AUA), an important study conducted by Prof. Guazzoni and his team, was presented. It highlighted the use of new markers for early diagnosis of recurrent tumors in patients who had already undergone radical prostatectomy (removal of the entire prostate gland). Prostate specific antigen (PSA) is a protein synthesized by prostate cells. It is normally present in small concentrations in the serum of men and it can be measured through a simple blood test. If a high percentage of this antigen is found, it is linked to various diseases of the prostate such as cancer, prostatic hypertrophy and prostatitis. “As of today – explains Dr. Lazzeri – the ultrasensitive PSA is recognized as the preferred tool for monitoring radical prostatectomy. This is because it allows recognition of a biochemical relapse outside of the standard PSA borders. Our studies have led to the identification of a marker even more accurate and reliable. It is known as the proPSA and it is able to measure concentrations in the order of picograms. Picograms are a thousand times smaller than the standard PSA, which is measured by nanograms.”


What aspects of the “Frozen Section” were addressed by Dr. Buffi?

Dr. Buffi, a member of the Society of Urological Surgery Robotics, also spoke at the AUA 2015 annual meeting. He held a speech entitled “Evaluation of Intraoperative Surgical Margins during Robotic Prostatectomy” (in other words, rating intraoperative margins during robotic prostatectomy). The intraoperative “frozen section” refers to the intraoperative analysis of prostate margins for the purpose of excluding the presence of malignant growths. To ensure the removal of the entire tumor mass, the adjacent healthy tissue must be immediately removed as well. This is done in order to avoid any local recurrence.  However, there is a risk associated with the invasiveness of the procedure. It can compromise the neurovascular bundles, causing urinary incontinence and sexual impotency.  “Thanks to this diagnostic tool – explains Dr. Buffi – we can exclude or confirm the need for a more radical intervention. This important diagnostic tool, created and presented by the Urology Department led by Dr. Guazzoni, as well as American Urologists – says Dr. Buffi – has been a great source of pride for us.”


What aspects of the study on active monitoring were addressed by Dr. Hurle?

Among the research studies presented at the AUA annual meeting, was also that of Dr. Rodolfo Hurle. Dr. Rodolfo Hurle is a consultant at the Operating Unit of Urology and Andrology in Humanitas. He presented his study on active monitoring as an alternative for surgery in patients with recurrent bladder cancer. The results were encouraging and confirmed the validity of observational therapy for monitoring of this disease.  The study showed that the patient is tested regularly and not treated by surgery if the tumor remains asymptomatic. Overall, the research was marked by strong innovation and opened up new therapeutic prospects.