{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T09:22:31Z","timestamp":1778145751421,"version":"3.51.4"},"reference-count":21,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Background: Our study aims to assess the feasibility and the reproducibility of fluorescent confocal microscopy (FCM) real-time assessment of urethral and ureteral margins during open radical cystectomy (ORC) for bladder cancer (BCa). Methods: From May 2020 to January 2022, 46 patients underwent ORC with intraoperative FCM evaluation. Each specimen was intraoperatively stained for histopathological analysis using FCM, analyzed as a frozen section (FSA), and sent for traditional H&amp;E examination. Sensitivity, specificity, positive predictive value (PPV), and the negative predictive value (NPV) of FCM and FSA were assessed and compared with H&amp;E for urethral and ureteral margins separately. Results: The agreement was evaluated through Cohen\u2019s \u03ba statistic. Urethral diagnostic agreement between FCM and FSA showed a \u03ba = 0.776 (p &lt; 0.001), while between FCM and H&amp;E, the agreement was \u03ba = 0.691 (p &lt; 0.001). With regard to ureteral margins, an overall agreement of \u03ba = 0.712 (p &lt; 0.001) between FCM and FSA and of \u03ba = 0.481 (p &lt; 0.001) between FCM and H&amp;E was found. Conclusions: FCM proved to be a safe, feasible, and reproducible method for the intraoperative assessment of urethral and ureteral margins during ORC. Compared to standard FSA, FCM showed adequate diagnostic performance in detecting urethral and ureteral malignant involvement.<\/jats:p>","DOI":"10.3390\/curroncol30030259","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T06:36:36Z","timestamp":1678862196000},"page":"3421-3431","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Real-Time Urethral and Ureteral Assessment during Radical Cystectomy Using Ex-Vivo Optical Imaging: A Novel Technique for the Evaluation of Fresh Unfixed Surgical Margins"],"prefix":"10.3390","volume":"30","author":[{"given":"Francesco","family":"Prata","sequence":"first","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umberto","family":"Anceschi","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Taffon","sequence":"additional","affiliation":[{"name":"Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9758-2099","authenticated-orcid":false,"given":"Silvia Maria","family":"Rossi","sequence":"additional","affiliation":[{"name":"Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Verri","sequence":"additional","affiliation":[{"name":"Unit of Endocrine Organs and Neuromuscular Pathology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2619-7465","authenticated-orcid":false,"given":"Andrea","family":"Iannuzzi","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Ragusa","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Esperto","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salvatore Mario","family":"Prata","sequence":"additional","affiliation":[{"name":"Simple Operating Unit of Lower Urinary Tract Surgery, SS. Trinit\u00e0 Hospital, 03039 Sora, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Crescenzi","sequence":"additional","affiliation":[{"name":"Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto Mario","family":"Scarpa","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4868-9025","authenticated-orcid":false,"given":"Giuseppe","family":"Simone","sequence":"additional","affiliation":[{"name":"Department of Urology, IRCCS \u201cRegina Elena\u201d National Cancer Institute, 00144 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9566-7243","authenticated-orcid":false,"given":"Rocco","family":"Papalia","sequence":"additional","affiliation":[{"name":"Department of Urology, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.eururo.2020.03.055","article-title":"European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2020 Guidelines","volume":"79","author":"Witjes","year":"2021","journal-title":"Eur. 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