Clinical genitourinary cancer最新文献

{"title":"Indeterminate Surgical Margins (Rx) in Renal Cell Carcinoma Surgery: Rates, Predictive Factors, and Impact on Overall Survival","authors":"Dejan K. Filipas ,&nbsp;José I. Nolazco ,&nbsp;Benjamin V. Stone ,&nbsp;Michael Rink ,&nbsp;Edoardo Beatrici ,&nbsp;Muhieddine Labban ,&nbsp;Stuart R. Lipsitz ,&nbsp;Margit Fisch ,&nbsp;Toni K. Choueiri ,&nbsp;Alexander P. Cole ,&nbsp;Quoc-Dien Trinh ,&nbsp;Steve L. Chang","doi":"10.1016/j.clgc.2025.102481","DOIUrl":"10.1016/j.clgc.2025.102481","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Indeterminate pathological margins (Rx) in renal cell carcinoma (RCC) surgery may affect overall survival. This study aims to evaluate Rx rates, identify predictive factors, and assess their impact on overall survival compared to negative margins (R0).</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 473,152 RCC patients from the National Cancer Database (2004-2020). Patients underwent partial or radical nephrectomy. The primary outcome was Rx at final pathology. Multivariable logistic regression and Cox proportional hazard regression were employed to identify predictors and assess survival impact.</div></div><div><h3>Key Findings and Limitations</h3><div>Rx was observed in 0.62% of cases. Partial nephrectomy, laparoscopic approach, and major vein involvement were associated with increased odds of Rx. Rx was linked to worse overall survival (adjusted Hazard Ratio 1.38; 95% CI, 1.22-1.57; <em>P</em> &lt; .01). Limitations include selection bias and data quality variations.</div></div><div><h3>Conclusions and Clinical Implications</h3><div>Our study indicates that Rx should not be considered equivalent to R0 resection status, as it is associated with worse overall survival in RCC. These findings may aid in the postoperative risk assessment of RCC patients and guide clinical decision-making.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102481"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949502","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":"Cabozantinib Beyond VEGFR Inhibition: Reprogramming the IO-Refractory Microenvironment in Metastatic RCC","authors":"Asim Armagan Aydin ,&nbsp;Erkan Kayikcioglu","doi":"10.1016/j.clgc.2025.102485","DOIUrl":"10.1016/j.clgc.2025.102485","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102485"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921102","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":"Real World Hospitalizations in US Veterans Treated for Metastatic Prostate Cancer with Combination Therapy","authors":"Kara Ingram ,&nbsp;Robert Wilson ,&nbsp;Jason M. Doherty ,&nbsp;Daniel B. Eaton Jr ,&nbsp;Sumrah Khan ,&nbsp;Martin W. Schoen","doi":"10.1016/j.clgc.2025.102469","DOIUrl":"10.1016/j.clgc.2025.102469","url":null,"abstract":"<div><h3>Introduction</h3><div>Treatment of metastatic hormone sensitive prostate cancer (mHSPC) has traditionally included combination therapy of androgen deprivation therapy (ADT) with docetaxel or an androgen receptor pathway inhibitor (ARPI). There are no comparative studies to compare the real-world hospitalization rates and adverse events (AEs).</div></div><div><h3>Material and Methods</h3><div>A nationwide retrospective study of 1549 US veterans was conducted to compare treatment with ADT+docetaxel (<em>n</em> = 500) versus ADT+ARPI (<em>n</em> = 1049) between 2013 and 2021. Hospitalizations were determined 1 year before and after treatment. Baseline cohort characteristics and incidence rate differences of adverse events were then compared in the year prior to treatment with the year after.</div></div><div><h3>Results</h3><div>In patients who received ADT+docetaxel, hospitalizations increased by 245%, and ADT+ARPI hospitalizations increased by 125% (<em>P</em> &lt; .001). The docetaxel cohort was younger and had fewer comorbidities (median age 66.8 vs. 73.4 years; CCI 1 vs. 2). Docetaxel had higher rates of hospitalizations due to digestive (+ 600%, <em>P</em> &lt; .001) and respiratory complications (+ 157%, <em>P</em> = .04). The ARPI cohort had increased hospitalizations due to respiratory (+ 243%, <em>P</em> &lt; .001), endocrine/metabolic (+ 80%, <em>P</em> = .002), and circulatory complications (+ 64%, <em>P</em> = .009). The ARPI cohort had a decrease in acute renal failure admissions (−24%, <em>P</em> = .401).</div></div><div><h3>Discussion and Conclusions</h3><div>Overall, in the real-world setting, the 2 therapy regimens have distinct hospitalization risks and AEs. Patients with respiratory and gastrointestinal comorbidities may be at higher risk when receiving treatment with docetaxel. Alternatively, older and frailer patients who are susceptible to infections and metabolic complications may be at increased risk with ARPIs. These findings may aid physicians in determining the optimal, individualized therapy to mitigate adverse outcomes in patients with mHSPC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102469"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145727684","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":"Treatment Patterns, Disease Recurrence, and Overall Survival in Patients With Muscle-Invasive Bladder Cancer After Radical Cystectomy: A Population-Level Claims-Based Analysis","authors":"Patrick Squires ,&nbsp;Erin E. Cook ,&nbsp;Yan Song ,&nbsp;Ching-Yu Wang ,&nbsp;Adina Zhang ,&nbsp;Shravanthi M. Seshasayee ,&nbsp;Aljosja Rogiers ,&nbsp;Haojie Li ,&nbsp;Ronac Mamtani","doi":"10.1016/j.clgc.2025.102466","DOIUrl":"10.1016/j.clgc.2025.102466","url":null,"abstract":"<div><h3>Introduction</h3><div>The treatment landscape for muscle-invasive bladder cancer (MIBC) is evolving, and the real-world clinical burden in patients undergoing radical cystectomy (RC) remains poorly characterized. This study evaluated treatment patterns, recurrence, and overall survival (OS) in patients aged ≥ 65 years who underwent RC for MIBC.</div></div><div><h3>Patients and methods</h3><div>Using the SEER-Medicare database (2007-2020), we identified patients with MIBC post-RC. Trends in treatment modality (RC alone [no neoadjuvant or adjuvant therapy], neoadjuvant therapy + RC only, RC + adjuvant therapy only, or both neoadjuvant and adjuvant therapy + RC) were summarized. Recurrence and OS were analyzed using Kaplan-Meier estimates overall and by disease stage (T2N0M0, T3-T4N0M0, T1-T4N1M0) and treatment modality. OS among patients with vs. without recurrence was compared using an adjusted Cox proportional hazards model.</div></div><div><h3>Results</h3><div>Among 1149 patients with MIBC (60.2% T2N0M0; 31.7% T3-T4N0M0; 8.1% T1-T4N1M0), 53.6% received RC alone; others received neoadjuvant therapy + RC (33.9%), RC + adjuvant therapy (10.2%), or both (2.3%). From 2007-2009 to 2019-2020, the proportion of patients treated with RC alone fell from 77.7% to 33.9% whereas neoadjuvant therapy + RC rose from 9.2% to 61.0%. The overall 5-year recurrence rate was 53.1%, varying by disease stage (T2N0M0: 46.0%, T3-T4N0M0: 61.1%, T1-T4N1M0: 77.7%) and treatment modality (RC alone: 51.4%, neoadjuvant therapy + RC: 47.6%, RC + adjuvant therapy: 69.3%, both: not estimable). The overall 5-year OS rate was 53.0%, varying by disease stage (T2N0M0: 61.3%; T3-T4N0M0: 42.6%; T1-T4N1M0: 33.6%) and treatment modality (RC alone: 48.2%; neoadjuvant therapy +RC: 66.9%, RC + adjuvant therapy: 42.0%, both: 38.0%). Patients with vs. without recurrence had significantly shorter OS (hazard ratio = 1.88, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>Patients with MIBC post-RC experience high recurrence rates and poor survival outcomes across stages and treatment modalities. Effective strategies to prevent or delay recurrence are urgently needed to improve long-term survival in this population.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102466"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733453","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":"Trimodality Therapy for Bladder Cancer: A Single Institution Retrospective Analysis of Factors Associated With Outcomes for High-Risk Patients Undergoing Organ-Sparing Therapy","authors":"Monica S. Nair ,&nbsp;Jessica Scarborough ,&nbsp;Chandana A. Reddy ,&nbsp;Anirudh R. Bommireddy ,&nbsp;Erin Brooks ,&nbsp;Nima Almassi ,&nbsp;Christopher J. Weight ,&nbsp;Steven Campbell ,&nbsp;Moshe C. Ornstein ,&nbsp;Amanda Nizam ,&nbsp;Timothy Gilligan ,&nbsp;Christopher Wee ,&nbsp;Shilpa Gupta ,&nbsp;Jacob G. Scott ,&nbsp;Anthony Mastroianni ,&nbsp;Rahul Tendulkar ,&nbsp;Omar Y. Mian","doi":"10.1016/j.clgc.2025.102477","DOIUrl":"10.1016/j.clgc.2025.102477","url":null,"abstract":"<div><h3>Purpose</h3><div>We sought to define patient and disease characteristics associated with outcomes after trimodality therapy (TMT) for high-risk nonmuscle invasive and muscle invasive bladder cancer (MIBC). A retrospective analysis of a large single institution cohort treated with bladder preservation therapy was performed to identify factors associated with survival.</div></div><div><h3>Methods and Materials</h3><div>Patients with high-risk non-MIBC or MIBC who underwent definitive bladder sparing treatment between 2006 and 2022 were included. Variables for analysis included age, sex, Charlson Comorbidity Index (CCI), surgical candidacy, neoadjuvant/induction chemotherapy (NAC), tumor size, presence of hydronephrosis, carcinoma in-situ, and histologic subtype. Kaplan–Meier analysis was done to calculate rates of overall survival (OS) and disease-free survival (DFS), while cumulative incidence analysis was done to calculate rates of cancer specific mortality (CSM) and local recurrence. Cox proportional hazards regression was done to identify factors associated with OS and DFS. Competing risk regression was done to identify factors associated with CSM and local recurrence.</div></div><div><h3>Results</h3><div>226 patients were included in the cohort with a median follow up of 18.9 months (range 0.9-172.3). The median age was 79 years (range 49-98) and 79.2% were male. On univariate Cox proportional hazards regression, younger age, NAC, and cystectomy candidacy were associated with improved OS (<em>P</em> &lt; .0001, HR = 1.05, 95% CI, 1.03-1.08; <em>P</em> = .04, HR = 0.62, 95% CI, 0.39-0.99; <em>P</em> &lt; .0001, HR = 0.42, 95% CI, 0.27-0.65; respectively). On multivariable analysis, only younger age and cystectomy eligibility were associated with improved OS (<em>P</em> = .002, HR = 1.04, 95% CI, 1.02-1.07; <em>P</em> = .006, HR = 0.52, 95% CI, 0.33-0.83; respectively).</div></div><div><h3>Conclusion</h3><div>This study finds cystectomy eligibility to be associated with improved survival and underscores the importance of multi-disciplinary assessment in determining candidacy for organ preserving therapy in MIBC patients.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102477"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145835589","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 FGFR3 Alterations on First-Line Platinum Based Chemotherapy in Patients With Metastatic or Locally Advanced Urothelial Carcinoma: The Retrospective IFUCA Study","authors":"Thibaut Reverdy ,&nbsp;Floriane Izarn ,&nbsp;Benoit Allignet ,&nbsp;Guilhem Roubaud ,&nbsp;Nyere Gibson ,&nbsp;Diego Teyssonneau ,&nbsp;Constance Thibault ,&nbsp;Hugo Berthou ,&nbsp;Nadine Houede ,&nbsp;Aude Fléchon ,&nbsp;Sophie Tartas ,&nbsp;Fabien Moinard-Butot ,&nbsp;Philippe Barthelemy ,&nbsp;Denis Maillet","doi":"10.1016/j.clgc.2025.102465","DOIUrl":"10.1016/j.clgc.2025.102465","url":null,"abstract":"<div><h3>Introduction</h3><div><em>FGFR3</em> alterations are observed in 10% to 15% of patients with advanced urothelial carcinoma (UC). We aimed to clarify the prognostic and predictive value of <em>FGFR3</em> alterations in patients receiving first-line platinum-based chemotherapy (PBC) for advanced urothelial carcinoma.</div></div><div><h3>Patients and Methods</h3><div>We conducted a multicenter retrospective cohort study including patients with histologically confirmed UC treated in first line with PBC, with or without immune-checkpoint inhibitors (ICIs) administered as maintenance or second line. Only patients with known <em>FGFR3</em> status on baseline tumor tissue, locally assessed were included. Progression-free survival (PFS) was the primary endpoint. Secondary endpoints included overall survival (OS), objective response rates (ORR), and PFS with ICIs, stratified by <em>FGFR3</em> status.</div></div><div><h3>Results</h3><div>Between 2016 and 2022, 191 pts were included, of whom 58 (30.4%) had <em>FGFR3</em>-altered tumors (<em>FGFR3</em>^alt). Baseline characteristics were well balanced. ICIs were administered to 34% of patients. After a median follow-up of 32 months, median PFS under PBC was 6.6 months in <em>FGFR3</em>^alt and 7.5 in <em>FGFR3</em> wild type subgroups (HR = 1.27; <em>P</em> = .15) respectively. Median OS was 22.1 versus 20.8 months (HR = 0.91; <em>P</em> = .658), and ORR in 133 pts were similar across subgroups (70.7% vs. 69.2% respectively). In multivariate analysis, <em>FGFR3</em> status was not associated with survival.</div></div><div><h3>Conclusions</h3><div><em>FGFR3</em> status did not significantly impact response to PBC in first-line treatment or ICIs. These findings underscore that the presence of an <em>FGFR3</em> alteration does not guide the choice of platinum-based treatment, and the need for prospective biomarker-driven trials to identify best treatment sequences in advanced UC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102465"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688818","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":"Attrition Rates in Metastatic Renal Cell Carcinoma (mRCC) Following First Line Immunotherapy-Based Treatment: Results From the International mRCC Database Consortium (IMDC)","authors":"Audreylie Lemelin ,&nbsp;Martin Zarba ,&nbsp;Kosuke Takemura ,&nbsp;J. Connor Wells ,&nbsp;Razane El Hajj Chehade ,&nbsp;Frede Donskov ,&nbsp;Camillo Porta ,&nbsp;Guillermo De Velasco ,&nbsp;Ian D. Davis ,&nbsp;Lori A. Wood ,&nbsp;Sumanta K. Pal ,&nbsp;Aaron R. Hansen ,&nbsp;Ben Tran ,&nbsp;Georg A. Bjarnason ,&nbsp;Haoran Li ,&nbsp;Ravindran Kanesvaran ,&nbsp;Thomas Powles ,&nbsp;Rana R. McKay ,&nbsp;Toni K. Choueiri ,&nbsp;Daniel Y.C. Heng","doi":"10.1016/j.clgc.2025.102484","DOIUrl":"10.1016/j.clgc.2025.102484","url":null,"abstract":"<div><h3>Background</h3><div>Attrition rates for patients with mRCC are not well characterized in the era of immunoncology (IO)-based combinations. This study aims to quantify real-world attrition rates by line of therapy, analyze associated clinical predictors, and describe treatment sequencing across multiple international centers.</div></div><div><h3>Methods</h3><div>IMDC data for patients with mRCC who received first line Nivolumab + Ipilimumab (IO-IO) or IO- Vascular Endothelial Growth Factor receptor targeted therapy (VEGFR TT) (IO-VE) were included. Clinical and pathologic characteristics and outcomes were extracted. Chi-square tests were used to compare categorical variables between patients who received second line and those who did not. A logistic regression model was used to assess predictors of second line therapy initiation.</div></div><div><h3>Results</h3><div>A total of 1411 patients were identified, of whom 995 patients were treated with first line IO-IO and 434 with IO-VE. Of them, 935 (704 first line IO-IO and 231 first line IO-VE) stopped first line and were suitable for second line therapy. Reasons for stopping first line included progressive disease (PD) in 41.1%, toxicity in 24.4%, death in 3.9%, complete response in 1.5% and other in 28.3%. Among second line suitable patients, 544 (58.2%) started any second line whereas 391 (41.8%) did not. Patients who stopped first line for PD were more likely to initiate second line than those who stopped for other reasons (57.9% vs. 17.6%, <em>P</em> &lt; .00001). Patients who received second line were more likely to have clear-cell histology (77.2% vs. 66.8%, <em>P</em> = .04), without sarcomatoid features (57.2 vs. 44.8%, <em>P</em> = .02), a Karnofsky performance score (KPS) of 80 or higher (80.1 vs. 73.9%, <em>P</em> = .01), and bone metastases (39.0 vs. 28.1%, <em>P</em> = .0009). (Table 2). After adjusting for IMDC criteria, only age and reason for stopping first line remained significant predictors of receiving second line therapy. Among 353 patients who stopped second line, 199 (56.4%, overall 21.3%) started third line therapy. Of the 139 patients who stopped third line, 80 (57.6%, overall 8.6%) started fourth line therapy.</div></div><div><h3>Conclusions</h3><div>In this real-world analysis, we found that just over half of suitable patients received the subsequent line of therapy post first line. We were able to identify age and reason for stopping first line as predictors of second line therapy initiation.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102484"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921101","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":"Metastasis Profile and Survival Outcomes of Metastatic Non-Muscle Invasive Bladder Cancer: A National Cancer Database Analysis","authors":"Mohamed Javid Raja Iyub ,&nbsp;Pushan Prabhakar ,&nbsp;Deerush Kannan Sakthivel ,&nbsp;Aditi Chandrasekaran ,&nbsp;Manuel Ozambela Jr ,&nbsp;Murugesan Manoharan","doi":"10.1016/j.clgc.2025.102462","DOIUrl":"10.1016/j.clgc.2025.102462","url":null,"abstract":"<div><h3>Introduction</h3><div>Metastatic non-muscle invasive bladder cancer (mNMIBC) is a condition in which bladder cancer patients develop metastasis in the absence of muscle invasion. The nature of mNMIBC is understudied due to its recent increased recognition. The study aimed to analyze the baseline characteristics, metastatic patterns, and survival outcomes of this condition.</div></div><div><h3>Methods</h3><div>A retrospective analysis of the National Cancer Database (NCDB) (2004-2021) was done to identify NMIBC patients who presented with distant metastasis at diagnosis, as defined in the NCDB. The patient characteristics, metastatic trends, and survival outcomes were analyzed. Multivariable logistic regression was performed to identify the variables associated with mNMIBC. Cox proportional hazards regression and Kaplan–Meier analysis were used to analyze the survival outcomes (overall survival).</div></div><div><h3>Results</h3><div>Among the 537,674 patients diagnosed with NMIBC, 3982 (0.74%) patients had metastasis. The most common sites of metastasis were the bone (15.3%), followed by the lung (13.6%), liver (7.1%), and brain (0.9%). Furthermore, 15.1% of patients had multiple metastases. The median overall survival (OS) for mNMIBC was 6.54 months (95% Confidence Interval [CI]: 6.04-7.03). The OS was poorer among patients with metastasis to multiple sites (median OS: 3.55 months; 95% CI, 3.05-4.04) compared to those with metastasis to a single site. The best OS in isolated metastasis was seen in lung metastasis (median OS: 8.48 months; 95% CI, 6.68-10.27), and the worst OS was seen in liver metastasis (median OS: 3.70 months; 95% CI, 2.80-4.56<strong>).</strong> Older age, higher Charlson comorbidity score, and non-urothelial histology were associated with worse OS (<em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>mNMIBC is an uncommon condition with poor OS. Metastases to multiple sites have a poorer prognosis than metastases to a single site. Among the single-site metastases, the most common metastatic site was bone, and the best OS was seen in lung metastasis.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102462"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552381","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":"Gleason Score 3 + 4 (Grade Group 2) Prostate Cancer on Biopsy and Postoperative Pathological Upgrading: A Systematic Review and Meta-Analysis","authors":"Shulin Wu ,&nbsp;Sharron X. Lin ,&nbsp;Adam S. Feldman ,&nbsp;Chin-Lee Wu ,&nbsp;Douglas M. Dahl","doi":"10.1016/j.clgc.2025.102461","DOIUrl":"10.1016/j.clgc.2025.102461","url":null,"abstract":"<div><div>The clinical heterogeneity of needle biopsy (Bx)3 + 4 presents uncertainty to active surveillance as a treatment option for prostate cancer (PCa) patients. This meta-analysis demonstrates that 23.4% of Bx3 + 4 were upgraded at radical prostatectomy (RP). Age, cT, PI-RADS, greatest percentage of cancer involvement in biopsy (GPC) and number of positive cores are independent upgrading predictors, while Bx approaches showed no significant difference. Current guidelines recognize active surveillance as a treatment option for patients with intermediate-risk (IR)-PCa including selected cases with a diagnosis of Bx3 + 4. However, the upgrading of Bx3 + 4 in the RP is a critical but unaddressed concern. We investigated pathological RP upgrading from Bx3 + 4 and assessed its impact on oncological outcomes. A systematic literature search was performed up to February 2025 to identify the eligible studies discussing Bx3 + 4 on adverse RP pathology. Meta-analyses were performed on parameters with available information. Forty-eight studies comprising 63,119 patients with matched Bx3 + 4 and subsequent RP pathology were included. The median incidence of Bx3 + 4 upgraded to RP ≥ 4 + 3 and to RP ≥ 8 was 23.4% (IQR: 18.3%-23.7%) and 3.6% (IQR: 2.7%-4.9%), respectively. Age, cT, PI-RADS, GPC and No. positive cores were identified as independent and significant predictors for upgrading in Meta-analyses. No significant differences in upgrading were observed between systematic Bx (SBx) and MRI-targeted biopsy (TBx) methods or Transrectal (TR) and transperineal (TP) approaches<em>.</em> RP upgrading from Bx3 + 4 occurred in 23.4% cases, who may have a significantly worse biochemical recurrence survival. Different Bx methods did not make a significant impact on the rate of Bx3 + 4 to RP ≥ 4 + 3 upgrading.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102461"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607363","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":"Trends in Treatment Patterns and Outcomes Among Patients Diagnosed With Nonmuscle-Invasive Bladder Cancer in the United States","authors":"Bernard Bright Davies-Teye ,&nbsp;Dominique Seo ,&nbsp;Abree Johnson ,&nbsp;Jennifer Stuart ,&nbsp;Mehmet Burcu ,&nbsp;Nader Hanna ,&nbsp;Eberechukwu Onukwugha ,&nbsp;M. Minhaj Siddiqui","doi":"10.1016/j.clgc.2025.102424","DOIUrl":"10.1016/j.clgc.2025.102424","url":null,"abstract":"<div><h3>Introduction</h3><div>Heterogeneity in disease presentation in nonmuscle invasive bladder cancer (NMIBC) creates significant variability in treatment patterns and outcomes across risk and clinical subgroups.</div></div><div><h3>Methods</h3><div>A descriptive analysis of NMIBC patients diagnosed between 2004 and 2017 using the National Cancer Database (NCDB), examined trends and patterns in treatment practices, postradical cystectomy (RC) outcomes, and survival overall and by subgroups. The American Urological Association/Society of Urologic Oncology risk stratification guideline was used to categorize patients into low-intermediate (LIR) and high-risk groups.</div></div><div><h3>Results</h3><div>Among newly diagnosed NMIBC patients (N = 324,646), 78.6% received TURBT without BCG, and 17.4% received BCG as part of their first course of treatment. Treatment patterns differed by risk groups. The high-risk group had lower TURBT without BCG than LIR (64.7% vs. 90.8%), but higher BCG (28.3% vs. 8.0%) and RC (5.5% vs. 0.5%). In the high-risk group, BCG and RC rates were higher in cT1/cTs than cTa patients. Over time, from 2004-2008 to 2013-2017, the use of BCG (12.6%-21.3%) and RC (2.2%-3.0%) increased, while TURBT-without BCG (84.3%-74.5%) decreased. Post-RC 90-day mortality was higher in high-risk than in LIR patients (4.6% vs. 2.8%). Five-year survival probabilities were unchanged over time. A post-hoc analysis revealed that 14% of patients received postoperative intravesical chemotherapy, with no notable differences in patient characteristics between this subgroup and the overall population.</div></div><div><h3>Conclusion</h3><div>Unmet medical needs for NMIBC patients persist, as many high-risk patients do not receive guideline-recommended care, and survival outcomes remain largely unchanged.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"24 1","pages":"Article 102424"},"PeriodicalIF":2.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508485","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}