Papers by Helena Vila Reyes
Frontiers in Oncology, May 18, 2022
The authors have requested that this preprint be removed from Research Square.
The Journal of Urology, 2020
INTRODUCTION AND OBJECTIVE:Multiparametric magnetic resonance imaging (mpMRI) of the prostate alo... more INTRODUCTION AND OBJECTIVE:Multiparametric magnetic resonance imaging (mpMRI) of the prostate along subsequent grading with the Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) scor...
Journal of Urology, 2021
INTRODUCTION AND OBJECTIVE:Correctly classifying patients with muscle invasive bladder cancer (MI... more INTRODUCTION AND OBJECTIVE:Correctly classifying patients with muscle invasive bladder cancer (MIBC) as achieving a complete response to neoadjuvant chemotherapy (NAC) is challenging without radica...
Cancers, 2021
Over the last few decades, changes in diagnostic and treatment paradigms have greatly advanced ca... more Over the last few decades, changes in diagnostic and treatment paradigms have greatly advanced cancer care and improved outcomes [...].
Archivos espanoles de urologia, 2019
OBJECTIVES Radical cystectomy (RC) is one of the most complex and morbid surgical procedures in U... more OBJECTIVES Radical cystectomy (RC) is one of the most complex and morbid surgical procedures in Urology. Several retrospective and prospective studies have demonstrated that robotic-assisted RC (RARC) represents a minimally invasive alternative to open surgery, showing non-inferiority in mid-term oncological outcomes. Moreover, important advantages related with perioperative complications have also been published. The aim of this article is to describe RARC surgical steps and to review the most relevant ndings in the eld of RARC, focusing on its strengths and weaknesses when compared with open RC. METHODS We performed a detailed step-by-step description of the RARC surgical technique, paying particular attention to its specific surgical details and adding our tips and tricks for an out standing performance. We also conducted a review of the most relevant articles in literature in terms of oncological, pathological and perioperative results. All these findings have been compared wit...
Diseases of the Colon & Rectum, 2021
Urologic Oncology: Seminars and Original Investigations, 2021
Frontiers in Oncology, 2020
Journal of Clinical Oncology, 2020
e17029 Background: Neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) is the standar... more e17029 Background: Neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) is the standard of care for muscle-invasive bladder cancer (MIBC). Prior studies have shown that pT0 response at RC can be attributed to NAC and high-quality transurethral resections (TURBT) prior to NAC. Therefore, we sought to assess the association of completeness of pre-NAC TURBT with response and survival outcomes. Methods: This was a single-institution, retrospective review of patients who received NAC for clinically localized MIBC (≥cT2, N0) from 2000 to 2017. Exclusion criteria were receipt of non-cisplatin-based NAC or radiation (n = 15), and insufficient documentation of TURBT (n = 26). Complete TURBT (cTURBT) was defined as tumor resection in entirety and/or resection to normal appearing muscle in operative reports, or repeat pre-NAC TURBT revealing clinical T0 (cT0). After NAC, patients either underwent repeat TURBT or immediate RC, as per the treating physician. Patients refusing RC were ...
The Journal of Urology, 2020
16 (59.3%) patients, respectively. The presence of TP53 alteration was associated with a longer o... more 16 (59.3%) patients, respectively. The presence of TP53 alteration was associated with a longer overall survival (27 monthes vs 13 monthes, P [ 0.024) (Figure 1 a). Similar survival advantage of TP53 mutation was also found in another cohort (11.7 monthes vs 2.3 monthes, P [ 0.024), although without statistically significance due to the small sample size (Figure 1 b). The correlation with longer overall survival remained significant in multivariable analysis that included presence of metastases (Table 1). Our subsequent research revealed that TP53 mutation was prominently associated with higher PD-L1/CD8A mRNA expression and increased mutational burden. It also facilitated expressions of T-effector and interferon-g related genes. CNV analysis based on the TCGA database displayed TP53 mutation boosted high level amplification of PD-L1. TP53 mutations altered a group of genes involved in cell-cycle regulating, DNA replication and damage repair. CONCLUSIONS: TP53 mutations are independently associated with improved survival from PD-1/PD-L1 blockade in patients with advanced urothelial cancers. Additional studis are warranted to evaluate the mechanisms that link TP53 mutations and immunotherapy response.
European Urology Supplements, 2019
Aim of the study: Contrast enhanced computed tomography (CT) is the gold standard imaging to dete... more Aim of the study: Contrast enhanced computed tomography (CT) is the gold standard imaging to detect upper tract urothelial carcinoma (UTUC). Recently, a higher rate of bladder recurrence in patients submitted to nephroureterectomy after diagnostic ureteroscopy (URS) for UTUC has been described. The aim of the study is to report on the correspondence between CT and URS findings and how it influences the therapeutic indication. Materials and methods: From 01/2015 to 09/2018, 101 consecutive patients with available CT were submitted to URS for UTUC. All CTs were performed within 45 days before surgery at 1.5-slice thickness. CT result was categorized as positive (n = 77) in case of pathologic/ suspicious lesions, as negative in case of no/unspecific alterations (n = 24). Correspondence between imaging, URS and histology was analyzed. Number, diameter and site of lesions were reported. Therapeutic indication after CT, stratified for low and high risk UTUC according to EAU Guidelines, was recorded. Chi-square test was used for categorical variables. Statistical significance was set at 0.05. Results: Eighty-seven (86.1%) patients had a UTUC on histology. CT sensitivity and specificity were 83% and 64%, respectively. A filling defect corresponded to UTUC in 59/61 (96.7%) cases while a urinary thickness (+/− stenosis) was present in 7/14 (50%) of patients with negative histology. Out of the 24 patients with negative CT, 15 (62.5%) had a neoplastic lesion on histology. 77 (100%) patients with positive CT had a visible lesion on URS; 72/77 (93.5%) were confirmed on cytology/histology. Out of these, URS detected 32/72 (44.4%) UTUCs with different characteristics compared to CT imaging (13 bigger/ smaller, 9 multifocal and 10 in other sites). So, the sensitivity of CT to detect and characterize UTUC lesions dropped to 46%. In fact, CT therapeutic indication was changed after URS in 24/101 (23.7%) patients. According to CT findings, 30/101 (29.7%) high risk cases should have been treated surgically (nephroureterectomy/ureterectomy). Out of these, surgical treatment was not indicated in 16 (53.3%) cases. On the other hand, 12/71 (17%) patients with no CT indication for surgery were managed with radical intervention (x2 = 9.7; p = 0.002). 4/16 (25%) patients were submitted to radical treatment after endoscopic management failure. URS allowed to spare the radical treatment in 12/87 (14%) cases (x2 = 6.6; p = 0.01) without UTUC progressions (mean follow-up 13 months). Discussion: CT accuracy to characterize UTUC lesions is low. URS should be considered a crucial step in the diagnostic pathway of UTUC even in case of CT-documented high risk tumours, since it may significantly change the treatment indication.
Journal of Urology, 2019
3 months during the first year after initial treatment, every 6 months in the 2nd year, and annua... more 3 months during the first year after initial treatment, every 6 months in the 2nd year, and annually thereafter. Demographic data and tumor characteristics were obtained for all patients. patients' courses were reviewed for tumor recurrence, grade progression and development of locally advanced or metastatic disease. Outcome of patients with tumor equal or larger than 2cm were compared to those of patients with tumor smaller than 2cm. RESULTS: During this period of time, 343 ureteroscopies (URS) were performed on 87 patients. Patients with High-grade disease on pathology, and patients with follow-up of 3 months or shorter were excluded. The cohort included 37 patients, 20 men, at a median age of 70 years. 13 patients had a tumor equal or larger than 2cm, while 24 had a tumor smaller than 2cm. Median tumor size was 30mm (range 20-40mm) and 10 mm (1-17mm) with a mean of 5.2 and 5.6 URS per patient (2-11) in the large and small-tumor groups, respectively. In the large-tumor group median follow-up time was 16 months (3-40), local recurrence rate was 46% after a mean of 4.9 months post URS and a mean recurrence size of 5.5mm. In the small-tumor group median follow-up time was 20 months (4-60), local recurrence rate was 71%, after a mean of 9.9 months post URS and a mean recurrence size of 5.8mm. No difference was found in local recurrence rate (p<0.553), of bladder tumor occurrence (p<0.253) between the groups. One patient in the large-tumor group developed high-grade disease and was referred to RNU after 12 months of ureteroscopic management. None of the patients in the cohort developed metastatic progression during the follow-up period. CONCLUSIONS: Ureteroscopic treatment of large upper tract urothelial carcinoma has good short-term oncologic outcome. Tumors larger than 2 cm tend to locally recur faster. Strict ureteroscopic surveillance might be considered for these cases.
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Papers by Helena Vila Reyes