Clinical genitourinary cancer最新文献

{"title":"Prognostic Implications of Patients With Clinically Node Positive Bladder Cancer Undergoing Radical Cystectomy","authors":"Pietro Scilipoti ,&nbsp;Marco Moschini ,&nbsp;Paolo Zaurito ,&nbsp;Mattia Longoni ,&nbsp;Mario De Angelis ,&nbsp;Luca Afferi ,&nbsp;Chiara Lonati ,&nbsp;Giovanni Tremolada ,&nbsp;Alessandro Viti ,&nbsp;Alfonso Santangelo ,&nbsp;Renate Pichler ,&nbsp;Andrea Necchi ,&nbsp;Francesco Montorsi ,&nbsp;Alberto Briganti ,&nbsp;Andrea Mari ,&nbsp;Wojciech Krajewski ,&nbsp;Ekaterina Laukthina ,&nbsp;Benjamin Pradere ,&nbsp;Francesco Del Giudice ,&nbsp;Laura Mertens ,&nbsp;Roberto Carando","doi":"10.1016/j.clgc.2025.102377","DOIUrl":"10.1016/j.clgc.2025.102377","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Patients with clinically node-positive (cN+) bladder cancer (BCa) form a biologically and prognostically diverse group. As systemic therapy reshapes management in this setting, this study examines oncological outcomes after radical cystectomy (RC) with or without perioperative systemic therapy.</div></div><div><h3>Materials and methods</h3><div>We utilized a multicenter, retrospectively collected database of 1067 patients diagnosed with cTanyN+M0 BCa who underwent RC with lymphadenectomy with or without perioperative systemic treatment. Patients with cN1-2 disease and treated from 2006 and 2023 were included. Three-months landmark Kaplan-Meier curves were used to estimate the overall survival (OS). Three-months landmark competing risk cumulative incidence curves were used to estimate the cancer specific mortality (CSM). Multivariable Cox regression models (MCR) were used to assess the association of treatment and pathology response (complete response [pCR], partial response [pPR] and pN0) with any cause death and cancer specific death.</div></div><div><h3>Results</h3><div>A total of 589 patients met the inclusion criteria, with 189 (32%) receiving preoperative systemic treatment (PST) and 115 (20%) undergoing RC + adjuvant therapy (AT). Median follow-up was 32 months. Three-year OS was 69% for PST + RC, 55% for RC + AT, and 55% for RC alone. PST + RC (HR: 0.67, <em>P</em> = .042) was associated with a lower risk of all-cause mortality at MCR. The 3-year CSM was 28% for PST + RC, 38% for RC + AT, and 32% for RC alone. Achieving pCR (HR: 0.31, <em>P</em> = .004), pPR (HR: 0.35, <em>P</em> &lt; .001), and pN0 (HR: 0.44, <em>P</em> &lt; .001) was associated with significantly lower risks of both all-cause and cancer-specific mortality.</div></div><div><h3>Conclusions</h3><div>Patients with cN+ BCa undergoing surgery show varied oncological outcomes. Those receiving PST and AT had longer OS, highlighting the importance of systemic therapy. The prognostic value of pCR, pPR, and pN0 supports the need for refined risk stratification to guide preoperative treatment and personalize care.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102377"},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erdafitinib versus Chemotherapy in Fibroblast Growth Factor Receptor-Altered Advanced or Metastatic Urothelial Cancer After Progression on Anti-programmed Death-(Ligand) 1 Therapy: An Exploratory Analysis of the Asian Subpopulation in the THOR Phase 3 Study","authors":"Nobuaki Matsubara ,&nbsp;Yohann Loriot ,&nbsp;Earle F. Burgess ,&nbsp;Se Hoon Park ,&nbsp;Robert A. Huddart ,&nbsp;Ja Hyeon Ku ,&nbsp;Ben Tran ,&nbsp;Jian Huang ,&nbsp;Yi-Hsiu Huang ,&nbsp;Kazuo Nishimura ,&nbsp;Nobuaki Shimizu ,&nbsp;Nianzeng Xing ,&nbsp;Wei Xue ,&nbsp;Rosemary Hemaya ,&nbsp;Jianmin Zhuo ,&nbsp;Kris Deprince ,&nbsp;Spyros Triantos ,&nbsp;Arlene O. Siefker-Radtke","doi":"10.1016/j.clgc.2025.102376","DOIUrl":"10.1016/j.clgc.2025.102376","url":null,"abstract":"<div><h3>Introduction</h3><div>The randomized phase 3 THOR study showed significantly longer survival with erdafitinib (pan-fibroblast growth factor receptor [FGFR] inhibitor) over chemotherapy in adults with <em>FGFR</em>-altered locally advanced or metastatic urothelial cancer (la/mUC) who had progressed during or after anti-programmed death-(ligand) 1 (anti-PD-[L]1) therapy (Cohort 1). This exploratory post-hoc analysis was conducted to evaluate the efficacy and safety of erdafitinib in the Asian subpopulation within THOR Cohort 1.</div></div><div><h3>Patients and methods</h3><div>Eligible patients were randomized in a 1:1 ratio to receive erdafitinib (8 mg once daily with pharmacodynamically guided up-titration to 9 mg) or chemotherapy (vinflunine or docetaxel once every 3 weeks). The primary endpoint was overall survival (OS).</div></div><div><h3>Results</h3><div>Seventy-six patients were included in the Asian subpopulation: 37 were randomized to erdafitinib and 39 to docetaxel. The median follow-up for survival was 15.7 months. The median OS was longer with erdafitinib than chemotherapy (23.3 months vs.11.3 months; hazard ratio [HR], 0.47; 95% confidence interval [CI], 0.23–0.96). One patient (2.7%) in the erdafitinib arm and 5 patients (15.2%) in the chemotherapy arm had grade 3 or 4 treatment-related serious adverse events (SAEs). One patient (2.7%) in the erdafitinib arm and 4 patients (12.1%) in the chemotherapy arm discontinued treatment due to treatment-related AEs.</div></div><div><h3>Conclusions</h3><div>Erdafitinib showed improved survival compared with chemotherapy, with no new safety concerns in the Asian subpopulation. These findings were consistent with those for the overall study population in THOR Cohort 1 who received prior anti-PD-(L)1 therapy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102376"},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Cytoreductive Nephrectomy in Contemporary Metastatic Renal Cell Carcinoma: An Other-Cause Mortality Match Population-Based Study","authors":"Marco Finati ,&nbsp;Giuseppe Ottone Cirulli ,&nbsp;Giuseppe Chiarelli ,&nbsp;Alex Stephens ,&nbsp;Shane Tinsley ,&nbsp;Chase Morrison ,&nbsp;Akshay Sood ,&nbsp;Nicolò Buffi ,&nbsp;Giovanni Lughezzani ,&nbsp;Andrea Salonia ,&nbsp;Alberto Briganti ,&nbsp;Francesco Montorsi ,&nbsp;Carlo Bettocchi ,&nbsp;Giuseppe Carrieri ,&nbsp;Craig Rogers ,&nbsp;Firas Abdollah","doi":"10.1016/j.clgc.2025.102374","DOIUrl":"10.1016/j.clgc.2025.102374","url":null,"abstract":"<div><h3>Objective</h3><div>A post-hoc analysis of CARMENA trial revealed that cytoreductive nephrectomy (CN) might still be beneficial for selected metastatic renal cell carcinoma (mRCC) patients. However, selection bias influences the choice of patients for CN, typically favoring those in better health and with a lower risk of all-cause mortality. We aimed to evaluate the impact of CN on cancer-specific mortality (CSM), using a cohort of mRCC patients matched for other-cause mortality (OCM).</div></div><div><h3>Methods</h3><div>The SEER database was queried to identify patients diagnosed with mRCC and treated with immunotherapy between 2010 and 2017. A Cox regression model calculating OCM was used to create a propensity score match cohort. Cumulative incidence curves depicted, and competing risks multivariable regression tested, the impact of CN versus no-surgery on CSM according to number of metastasis sites.</div></div><div><h3>Results</h3><div>Our match yielded to 1148 patients equally distributed between CN and no-surgery arm, with no difference in OCM (HR: 0.88, 95% CI: 0.53-1.47, <em>P</em> = .6). When stratifying patients for number of metastases sites, nonsurgery arm was associated with higher CSM rates for patients with 1 (HR: 1.93, 95% CI: 1.54-2.41, <em>P</em> &lt; .001) or 2 sites (HR: 1.54, 95% CI: 1.27-1.86, <em>P</em> &lt; .001). Conversely, no difference in CSM were observed for 3 or more sites (HR: 1.35, 95% CI: 0.93-1.97, <em>P</em> = .1).</div></div><div><h3>Conclusions</h3><div>In a matched cohort of mRCC patients treated with immunotherapy and comparable OCM risk, CN provided a CSM advantage for patients with up to 2 metastatic sites. This advantage was not observed in case of 3 or more sites.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102374"},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Muscle Depletion on Prognosis in Patients Undergoing Radical Cystectomy","authors":"Xiangyu Pang,&nbsp;Lei Jiang,&nbsp;Haiyun Wang,&nbsp;Lei Luo,&nbsp;Tongpeng Liu,&nbsp;Lijiang Sun,&nbsp;Guiming Zhang","doi":"10.1016/j.clgc.2025.102373","DOIUrl":"10.1016/j.clgc.2025.102373","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the prognostic impact of preoperative muscle depletion (including sarcopenia and myosteatosis) in patients with bladder cancer (BCa) after radical cystectomy (RC).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 185 patients undergoing RC for urothelial carcinoma. We used the computed tomography images at the L3 level of patients to get the skeletal muscle index (SMI) and skeletal muscle density (SMD). Sarcopenia is defined by the SMI while myosteatosis is defined by SMD. We used univariate Cox regression analysis to identify risk factors and included these risk factors in a multivariate Cox regression analysis to calculate the hazard ratio (<em>HR</em>) and 95% confidence interval (<em>95% CI</em>).</div></div><div><h3>Results</h3><div>In the univariate Cox analysis, sarcopenia (<em>P &lt; .</em>001) and myosteatosis (<em>P = .</em>017) were both associated with poorer overall survival (OS). Meanwhile, sarcopenia (<em>P &lt; .</em>001) and myosteatosis (<em>P = .</em>019) were both associated with poorer progression-free survival (PFS). In the multivariate Cox analysis, sarcopenia was identified as an independent risk factor for both OS (<em>P = .</em>018) and PFS (<em>P = .</em>005), whereas myosteatosis was not an independent risk factor for OS (<em>P = .</em>225) or PFS (<em>P = .</em>104).</div></div><div><h3>Conclusions</h3><div>Preoperative muscle depletion (including sarcopenia and myosteatosis) significantly correlates with poor prognosis of patients undergoing RC. Sarcopenia is an in dependent risk factor for 5-year OS and PFS. Our nomogram models demonstrated good predictive accuracy. Preoperative identification of muscle depletion and tailored interventions (exercise and nutrition) may improve postoperative outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102373"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utilization Patterns and Survival in Older Men With Metastatic Prostate Cancer Treated with Radium-223 in the United States: A SEER-Medicare Study","authors":"Bo Zhou ,&nbsp;Amit D. Raval ,&nbsp;Yifan Zhang ,&nbsp;Nethra Sambamoorthi ,&nbsp;Matthew J. Korn ,&nbsp;Niculae Constantinovici ,&nbsp;Rana McKay ,&nbsp;Usha Sambamoorthi","doi":"10.1016/j.clgc.2025.102372","DOIUrl":"10.1016/j.clgc.2025.102372","url":null,"abstract":"<div><h3>Introduction</h3><div>Previous research on Radium-223 treatment patterns in metastatic prostate cancer has been limited to select sites, oncology practices, or claims databases. Limited data exists on the use and outcomes of Radium-223 in Medicare population the largest public insurance provider for people aged 65 years and older in the United States. Therefore, this study used a nationwide population database of cancer registries linked to Medicare claims to examine Ra-223 treatment patterns, factors associated with treatment completion, and their associations with survival outcomes.</div></div><div><h3>Patients and Methods</h3><div>A retrospective cohort analysis was conducted on 1062 Medicare beneficiaries (≥ 66 years) with prostate cancer who initiated Ra-223 treatment between January 2016 and June 2020. Eligible men had 12 months of continuous Medicare Parts A/B/D enrollment prior to Ra-223 initiation and were followed for a minimum of 6 months. Primary outcomes included completion of ≥ 5 cycles of Ra-223 and overall survival. Factors influencing completion were analyzed with multivariate logistic regression, and survival was estimated using Kaplan-Meier and proportional hazards regressions.</div></div><div><h3>Results</h3><div>The cohort was 79.9% nonhispanic White, 6.8% Hispanic, and 6.1% nonhispanic Black, with a mean age of 75.6 years (SD = 6.6). Overall, 59.4% completed ≥ 5 cycles. Men receiving Ra-223 as first-line (21.1%) or second-line metastatic castration-resistant prostate cancer(mCRPC) therapy (44.1%) were more likely to complete treatment than those receiving third-line or later (aOR = 1.76,1.56, 95% CI, [1.22-2.54], [1.17-2.08]). Completing ≥ 5 cycles of Ra-223 was associated with longer survival (18.5 vs. 11.1 months, <em>P</em> &lt; .001; aHR = 0.51, 95% CI, [0.44, 0.59]), as was first- or second-line therapy use (18.4, 14.8 months vs. 13.8 months, <em>P</em> &lt; .001; aHR = 0.56,0.82; 95% CI, [0.45-0.68], [0.69-0.96]) compared to Ra-233 as third-line or later.</div></div><div><h3>Conclusion</h3><div>The majority of men received ≥ 5 cycles of Ra-223. Early initiation of Ra-223 was associated with higher completion rates and better survival outcomes, underscoring the importance of early Ra-223 use in managing mCRPC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102372"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radical Prostatectomy Versus Radiation Therapy for Locally Advanced and Clinically Nodal Positive Prostate Cancer","authors":"Mike Wenzel ,&nbsp;Katrin Burdenski ,&nbsp;Nikolaos Tselis ,&nbsp;Claus Rödel ,&nbsp;Christian Brandts ,&nbsp;Marit Ahrens ,&nbsp;Jens Koellermann ,&nbsp;Markus Graefen ,&nbsp;Hans Heinzer ,&nbsp;Alexander Haese ,&nbsp;Clara Humke ,&nbsp;Carolin Siech ,&nbsp;Severine Banek ,&nbsp;Felix K.H. Chun ,&nbsp;Philipp Mandel","doi":"10.1016/j.clgc.2025.102370","DOIUrl":"10.1016/j.clgc.2025.102370","url":null,"abstract":"<div><h3>Introduction</h3><div>Radical prostatectomy (RP) and radiation therapy (RT) are both recommended as standard-of-care for advanced prostate cancer (aPCa). However, data on comparisons for aPCa are scant.</div></div><div><h3>Patients and Methods</h3><div>We relied on the University Cancer Center database to investigate outcomes in metastasis-free (MFS), cancer-specific (CSS) and overall survival (OS) of cT3-4 and cN1 RP versus RT-treated patients between 2014 and 2024.</div></div><div><h3>Results</h3><div>Of 1017 cT3-4 patients, 93% underwent RP, which were significantly younger (67 vs. 75 years) and harbored significantly lower PSA level (9.3 vs. 12.7 ng/ml). Moreover, significant higher rates of ISUP4-5 in RT patients were observed (51% vs. 37%, <em>P</em> = .001). Univariable MFS, CSS and OS outcomes did not differ for cT3-4 patients. In multivariable adjusted MFS, CSS and OS outcomes also no difference between RP vs. RT-treated cT3-4 patients were observed (all <em>P</em> &gt; .05). Of 239 cN1 patients, 87% underwent RP, which were also younger (66 vs. 73 years, <em>P</em> &lt; .001) and with clinically meaningful lower PSA level (15.4 vs. 29.0 ng/ml, <em>P</em> = .09), relative to RT patients. In univariable MFS analyses, RT provided better results, with no differences for CSS and OS. However, after multivariable adjustment MFS, CSS and OS analyses showed no significant differences between RP vs. RT-treated cN1 patients (all <em>P</em> &gt; .05).</div></div><div><h3>Conclusion</h3><div>Real-world evidence of currently RP vs. RT-treated locally advanced cT3-4 and clinically node-positive prostate cancer patients suggest equally efficient cancer-control outcomes such as MFS, CSS and OS when adjusting for different patient and tumor characteristics and show excellent cancer control rates in this very-high risk cohort.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102370"},"PeriodicalIF":2.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Rheumatoid Arthritis, Frailty Status, and Mortality in Older Adults with Bladder Cancer","authors":"Maya Swaminathan ,&nbsp;Sarah K Holt ,&nbsp;John L. Gore ,&nbsp;Yaw A. Nyame ,&nbsp;Jonathan Wright ,&nbsp;Ami Shah ,&nbsp;Jeffrey A. Sparks ,&nbsp;Una E. Makris ,&nbsp;Petros Grivas ,&nbsp;Maria Suarez-Almazor ,&nbsp;Sarah Psutka ,&nbsp;Namrata Singh","doi":"10.1016/j.clgc.2025.102369","DOIUrl":"10.1016/j.clgc.2025.102369","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate the associations between rheumatoid arthritis (RA) and all-cause (ACM) and cancer-Specific mortality (CSM) in older adults with bladder cancer and examine how frailty may affect these associations.</div></div><div><h3>Methods</h3><div>Retrospective cohort study derived from the Surveillance Epidemiology and End Results (SEER) cancer registry and linked to Medicare claims data (SEER-Medicare). The cohort consisted of patients ≥ 65 years diagnosed with bladder cancer between 2004 and 2017. RA and frailty status were derived using validated administrative algorithms. ACM and CSM as derived from the SEER registry.</div></div><div><h3>Results</h3><div>Frailty modified the relationship between RA and mortality outcomes (interaction <em>P</em> value for ACM: .002 and for CSM: .007). We observed that RA was associated with a higher risk of CSM (aHR 1.17, 95% CI, 1.01-1.35) and ACM (aHR 1.12, 95% CI, 1.05-1.20) in nonfrail patients. In frail patients with bladder cancer, RA was not independently associated with CSM (aHR 0.81, 95% CI, 0.62-1.06) or ACM (aHR 0.93, 95% CI, 0.83-1.05).</div></div><div><h3>Conclusion</h3><div>Frailty is associated with adverse health outcomes. As people are living longer, it is becoming increasingly prevalent among patients with chronic conditions such as RA. We observed that RA is associated with increased risk of ACM and CSM among nonfrail older adults with bladder cancer. The lack of an association between RA and mortality in frail patients with RA suggests that the effect of frailty on mortality may overpower the effect that RA may exert—this information can help prognosticate outcomes in patients with bladder cancer, RA, and frailty.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102369"},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144164295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis, Treatment and Survival From Testicular Cancer: Real-World Data From the National Health Service England Between 2013 and 2020","authors":"Karl H. Pang ,&nbsp;Hussain M. Alnajjar ,&nbsp;Asif Muneer","doi":"10.1016/j.clgc.2025.102367","DOIUrl":"10.1016/j.clgc.2025.102367","url":null,"abstract":"<div><h3>Introduction</h3><div>The National Disease Registration Service (NDRS) collects and curates data on cancer diagnoses in England. This study analyzed testicular cancer (TC) data from 2013 to 2020.</div></div><div><h3>Patient and Methods</h3><div>Data were extracted from the NDRS “Get Data Out” database. The incidence per year, routes to diagnosis (RTD), treatment modalities and overall survival were analyzed.</div></div><div><h3>Results</h3><div>Between 2013 to 2020, 15,921 TC were diagnosed. The majority of cases were seminomatous germ cell tumors (SGCT) (61.4%), followed by nonseminomatous germ cell tumors (NSGCT) (33.6%). The annual incidence remained relatively stable, with 2010 cases in 2013 and 2023 cases in 2019. The majority of patients were ≥30 years (72.4%). Most cases (64%) were diagnosed with stage I disease, with a rising incidence observed in stage I NSGCTs. The primary RTD was the 2-week-wait (2ww) cancer pathway (59.1%), followed by GP referrals (15.7%) and emergency presentations (8.9%). A total of 90.4% of TC were treated with surgery, with or without chemotherapy, regardless of the histological subtype. Stage II-III disease more commonly underwent surgery combined with chemotherapy compared to stage I disease (65.7% vs. 46.8%, <em>P</em> &lt; .0001). The 12, 24, and 60-month survival was 98.0%, 96.9%, and 95.6% respectively. Stage I disease and SGCT were associated with better survival outcomes (<em>P</em> &lt; .001). Missing data from this dataset is a limitation.</div></div><div><h3>Conclusion</h3><div>The incidence of TC in England is relatively stable. Most TC were diagnosed via the 2ww cancer pathway. Surgery was the primary treatment modality and survival rates have remained relatively stable over time. Real-world data provide a cost-effective, time-efficient source of information to guide disease epidemiology, diagnostics, treatments, and outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102367"},"PeriodicalIF":2.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-Dense Docetaxel and Radium-223 in Bone-Dominant Metastatic Castration-Resistant Prostate Cancer","authors":"Brendan Connell ,&nbsp;Clara Hwang ,&nbsp;Edmund Folefac ,&nbsp;Christian Lawlor ,&nbsp;Benjamin Koethe ,&nbsp;Paul Mathew","doi":"10.1016/j.clgc.2025.102368","DOIUrl":"10.1016/j.clgc.2025.102368","url":null,"abstract":"<div><h3>Background</h3><div>Disease progression in castration-resistant prostate cancer (CRPC) remains bone-dominant and docetaxel-responsive. Docetaxel and radium-223 would be a logical combination but myelosuppression is dose-limiting. Dose-dense schedules of docetaxel have comparable activity to bolus dosing with mitigated myelosuppression. We hypothesized that dose-dense docetaxel with standard radium-223 would be a feasible, safe and effective combination in bone-dominant metastatic CRPC.</div></div><div><h3>Methods</h3><div>Subjects had progressive bone-predominant CRPC. Design was dose escalation plus expansion with 28-day cycles. Docetaxel was given every 2 weeks in a 4-week lead-in, then with Radium-223 every 4 weeks up to 6 cycles. Dose-levels (DL) included 1: docetaxel 40 mg/m²; 1a: docetaxel 40 mg/m² with G-CSF on Day 16, 2a: docetaxel 50 mg/m² with G-CSF on Day 16. The maximum tolerated dose (MTD) was defined as the highest (DL) of docetaxel achieved without dose-limiting toxicity (DLT). Markers of safety and efficacy were annotated.</div></div><div><h3>Results</h3><div>Forty-three subjects were enrolled (NCT03737370). The patient population included 21% black, 9% Asians, 93% had prior intensified hormonal therapy, 67% had bone pain, and 76% had ≥ 4 bone metastases. Seven patients dropped out during the 4-week docetaxel lead in. Neutropenia at DL 1 limited combination therapy. No (DLT) occurred at DL 1a (<em>n</em> = 6) or DL 2a (<em>n</em> = 5). Twenty-two patients were enrolled to an expansion cohort with docetaxel 50 mg/m² with G-CSF on Day 16 (DL 2a), the designated MTD. Among 35 patients treated with the combination, there were no febrile neutropenia events. One patient had dose-limiting Grade 3 anemia. PSA50 response was 51.4% and PSA90 was 25.7%. Median progression-free survival was 11.7 months, and median overall survival was 20.1 months.</div></div><div><h3>Conclusions</h3><div>A lead-in cycle and a dose-dense schedule of docetaxel with G-CSF enabled the combination with radium-223 in standard dose-intensities with minimal hematological toxicity. The regimen will likely combine logically and safely with hormone-intensification for study in high-risk/high-volume castration-sensitive metastatic disease.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102368"},"PeriodicalIF":2.3,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utility of Contemporary Community-Based Prostate Cancer Screening Campaigns","authors":"Nassib Abou Heidar,&nbsp;Zhe Jing,&nbsp;Richard Satterwhite,&nbsp;Bradley Webster,&nbsp;Eric C. Kauffman,&nbsp;Qiang Li,&nbsp;Khurshid A. Guru,&nbsp;Ahmed A. Hussein","doi":"10.1016/j.clgc.2025.102366","DOIUrl":"10.1016/j.clgc.2025.102366","url":null,"abstract":"<div><h3>Introduction</h3><div>While early detection of prostate cancer (PCa) might provide benefits in terms of PCa mortality, this might be associated with overdiagnosis and overtreatment of indolent cancers. We aimed to evaluate our community-based PCa early-detection campaigns.</div></div><div><h3>Methods</h3><div>A retrospective review of 19 PCa early-detection campaigns led by our institution was conducted between 2015 and 2023. These campaigns included PSA testing and digital rectal examinations (DRE) for all comers, followed by elective workup of at-risk patients, with follow-up PSA testing and multiparametric MRI (mpMRI). Data were reviewed for demographics and clinical parameters. Descriptive statistics were used to describe the data. Logistic regression was used to identify the factors associated with diagnosis of PCa.</div></div><div><h3>Results</h3><div>1171 men were included with median PSA of 1.1 ng/ml (IQR 0.6-2.5). Eighty seven men (7.4%) underwent prostate biopsy. Of those, 66 (76%) were diagnosed with prostate cancer (14% with Gleason grade group (GG) 1 and 86% with GG2 or higher—clinically significant prostate cancer (csPCa). Higher PSA (OR 1.62, 95% CI 1.42-1.85, <em>P</em> &lt; .0001) and suspicious DRE (OR 97, 95% CI 38-248, <em>P</em> &lt; .0001) were associated with diagnosis of csPCa. The number needed to screen to diagnose 1 case of PCa was 18 (95% CI 14-22) and the number needed to screen to diagnose 1 case of csPCa was 21 (95% CI 16-27).</div></div><div><h3>Conclusion</h3><div>Herein we describe our experience with contemporary PCa screening campaigns combining traditional screening with PSA and DRE with prostate MRI and judicious use of prostate biopsy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102366"},"PeriodicalIF":2.3,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}