Tony Finelli

MD, MSc, FRCSC

Chief of Urology, University Health Network
GU Site Lead, Princess Margaret Cancer Center
Associate Professor
University of Toronto

Phone

(416) 946-2851

Assistant(s)

Biography

Dr. Tony Finelli is a urologic oncologist and surgeon investigator at the University Health Network (UHN) in Toronto and an Associate Professor at the University of Toronto. He is the Chief of Urology, GU Site Lead at the Princess Margaret Cancer Center and the inaugural GU Oncology Lead for the province of Ontario (Cancer Care Ontario).

Dr. Finelli conducts health services research in urologic oncology with an interest in identifying gaps in care and designing knowledge translation strategies to overcome them. He is also actively involved in clinical trials. He has published more than 100 peer-reviewed manuscripts and holds peer-reviewed funding for research in prostate and kidney cancer.

Dr. Finelli’s clinical practice focuses on the management of urologic malignancies with minimally invasive and robotic techniques. He has performed live surgery for instructional purposes in more than 10 countries. Dr Finelli is recognized nationally and internationally for his contributions to minimally invasive urologic oncology.

Areas of Specialty and Research Interests

Affiliated Hospital(s)

Princess Margaret Cancer Centre (UHN), Toronto General Hospital (UHN)
 
 

Latest Publications

Extended Venous Thromboembolism Prophylaxis After Radical Cystectomy: A Call for Adherence to Current Guidelines.

Related Articles

Extended Venous Thromboembolism Prophylaxis After Radical Cystectomy: A Call for Adherence to Current Guidelines.

J Urol. 2017 Nov 04;:

Authors: Klaassen Z, Arora K, Goldberg H, Chandrasekar T, Wallis CJD, Sayyid RK, Fleshner NE, Finelli A, Kutikov A, Violette PD, Kulkarni GS

Abstract
PURPOSE: Radical cystectomy (RC) is an inherently morbid procedure. The purpose of this review is to assess the timing and incidence of venous thromboembolism (VTE), review current guideline recommendations, and provide evidence for considering extended VTE prophylaxis among all patients undergoing RC.
MATERIALS AND METHODS: We conducted a PubMed search of available literature for RC and VTE, focusing on: incidence and timing, evidence supporting extended VTE prophylaxis (among RC and abdominal surgical oncology patients), current guideline recommendations, safety considerations, and direct oral anticoagulants. The search terms used included radical cystectomy, venous thromboembolism, prophylaxis, extended, and direct oral anticoagulants alone or in combination. Relevant articles were reviewed including original research, reviews and clinical guidelines. References from review articles and guidelines were also assessed to develop a narrative review.
RESULTS: The incidence of symptomatic VTE in short-term follow-up after RC is 3-11.6% of patients, of which more than 50% will occur after hospital discharge. Meta-analyses of clinical trials for patients undergoing major abdominal surgical oncology procedures suggests decreased risk of VTEs for patients receiving extended (4 weeks) VTE prophylaxis. Extended prophylaxis should be considered for all RC patients; although the relative risk of bleeding also increases, the overall net benefit of extended prophylaxis clearly favors use for at least 28 days post-operatively. Extra-renal eliminated prophylaxis agents are preferred given the risk of renal insufficiency in RC patients, with newer oral anticoagulants providing an alternative route of administration.
CONCLUSIONS: Patients undergoing RC are at high risk for VTE after hospital discharge. There is strong evidence that extended prophylaxis significantly decreases the risk of VTEs in surgical oncology patients. The use of extended prophylaxis post-RC has been poorly adopted, emphasizing the need for better adherence to current urology procedure specific guidelines, as extended prophylaxis for RC is the standard of care. Specific and typically rare circumstances may require case-by-case assessment.

PMID: 29113840 [PubMed - as supplied by publisher]