Luca Antonelli

primary RPLND in CSIIa/b germ cell tumours+-adjuvant chemotherapy in >300 men, largest cohort published 📊 1/3 had no cancer in removed nodes, cave overtreatment 🎯 Larger marker neg nodes predict teratoma, resection in selected 2b 💉 2 cycles adj chemo after surgery at max

FREE fulltext paper link below: When I started performing radical cystectomies, I always struggled with how to stop and restart anticoagulation perioperatively. 🙄 😮 I then asked myself why this is such a common clinical scenario. I realized that many cystectomy patients develop venous thromboembolic events DURING neoadjuvant chemotherapy, a phenomenon we had already observed and studied in testis cancer patients (pubmed.ncbi.nlm.nih.gov/3303…) Together with our talented fellow @AntonelliMD , we started to collect data from 28 institutions. It involved a lot of paperwork and emails, but the most challenging part was the statistical analysis with the clever team around @ulrike_held . This work changed our way of management and may change clinical practice in your institution as well? Our new standard of care: 💉 thromboprophylaxis starting with neoadjuvant chemotherapy until 30d after cystectomy 🛡 (unless contraindicated) This is based on our just published analysis, which represents the largest international cohort of 4,886 patients with data specifically collected for this research question. After extensive statistical analyses, our results (with obvious limitations) suggest that, similar to findings in randomized controlled trials in other similar settings, thromboprophylaxis not only lowers the risk of venous thromboembolism but also potentially reduces the risk of bleeding. This is probably because fewer thromboses occur, which would otherwise necessitate full anticoagulation down the line. In an upcoming paper, we show that the Khorana Score is not useful in this setting; thromboprophylaxis for "everyone" is a clear pathway. Hopefully this will stimulate discussions in the @Uroweb guideline panel? Read free fulltext here: doi.org/10.1111/bju.16444 @UniLuzern @UZH_ch Many thanks to the fabulous collaboration with: @EAU_YAUrotheli @Luca_Afferi , Costantino Leonardo, @fraesperto , @MarkBorghesi1 , @aleantonellibs1 , @tully_karl , @PaoloUmari , @albisinnidoc , Andrea Mari, @Renate_Pichler, @FraClaps , @jteoh_hk, Mathieu Roumiguie, Gerald Bastian Schulz, @luca_orecchia , @frasor86, @MRoupret , @gautiermarcq , @CPMS1B , @MajedAlRumayyan , @MichaelRink_MD, @stefaniazambon1 , María Riaza Montes, Steven Okoye, @Ric_Campi @wojciechpiotrk1 , @LAUrology_NL , Meftun Culpan, @Luke Lavallée, @UroMoschini

📢 Exciting update from our latest analysis, published in the @JCO_ASCO How to treat men with vital residuals in the pcRPLND specimen? MORE chemo or only follow-up? 👇 ascopubs.org/doi/abs/10.1200… 🧵

🚨 our bladder neck/vesicourethral anastomosis technique led to promising continence - 91% no pads at all at 1y - early continence (median loss of 23g/24h only the day after catheter revmoval nice video and openAccess, @AntonelliMD @Luca_Afferi @AgostinoMattei

🦠 🦠 🦠 infectious complications are common after cystectomy. We reviewed the prevalence and potential preventive actions in the @ErasSociety cystectomy guideline panel 👁️Great research niche as antibiotics influence microbiome and response to immuno? sciencedirect.com/science/ar…

5/5 thx for this int initiative supported by numerous institutions in particular the following twitter users @AntonelliMD @PrafulRavi1 @AdityaBagrodia @siadaneshmand @giannatempopatr @Saouduro @uroegg @kathleenolsonmd @NaounNatacha @nabiladra @CaryClint @ChrisSweens1