Clinical genitourinary cancer最新文献

{"title":"Impact of Extended Versus Limited Lymph Node Dissection on Surgical Outcome, Recurrence Patterns and Survival After Radical Cystectomy","authors":"Mulham Al-Nader ,&nbsp;Ulrich Krafft ,&nbsp;Christopher Darr ,&nbsp;Jochen Heß ,&nbsp;Claudia Kesch ,&nbsp;Lukas Püllen ,&nbsp;Tibor Szarvas ,&nbsp;Henning Reis ,&nbsp;Stephan Tschirdewahn ,&nbsp;Boris A. Hadaschik ,&nbsp;Osama Mahmoud","doi":"10.1016/j.clgc.2025.102337","DOIUrl":"10.1016/j.clgc.2025.102337","url":null,"abstract":"<div><h3>Background</h3><div>The aim of our study is to evaluate the impact of extended versus limited lymph node dissection (LND) in patients undergoing radical cystectomy (RC) on survival, perioperative outcomes and pattern of recurrence.</div></div><div><h3>Patients and methods</h3><div>We reviewed our charts to identify patients who underwent RC and LND with curative intent between January 2003 and November 2022. Standard open RC with limited or extended LND was routinely performed, depending on surgeon's preference. The upper limit of extended LND is usually the ureteral crossing with the common iliac artery, unless further extension to the aortic bifurcation or inferior mesenteric artery is clinically indicated. Whereas limited LND includes removal of external and internal iliac and obturator Lymph nodes (LNs). The primary outcome was to compare the 2 patient groups in terms of cancer-specific survival (CSS) and overall survival (OS). The secondary outcome was to assess the impact of the extent of LND on the pattern of recurrence (local and distant metastasis free-survival) and perioperative complications.</div></div><div><h3>Results</h3><div>Of 642 patients, 439 and 203 underwent limited and extended LND, respectively. In the extended LND group, the median number of LNs removed was 23 compared to 8 in the limited LND group (<em>P</em> &lt; .001), which was associated with higher median positive LNs in the extended group (3 vs. 2, <em>P</em> = .05). Extended LND was associated with longer operative time (300 vs. 250 min., <em>P</em> &lt; .001), but not with blood loss, postoperative hemoglobin drop, hospital stay, 90-days major complications and hospital readmission rates. Lymphocele requiring surgical intervention was higher in extended group (7.4% vs. 1.8%, <em>P</em> = .001). The median follow-up time of survivors was 41 months in the limited group and 52 months in the extended group, (<em>P</em> = .1). Overall, 127 (29%) and 52 (26%) patients in the limited and extended groups experienced clinical recurrence (<em>P</em> = .39). At multivariable Cox regression analysis, LND template was not associated with either local and distant metastasis-free survival or CSS, while resection of ≥16 LNs was an independent predictor of local recurrence-free survival (HR 0.54; <em>P</em> = .01) and CSS (HR 0.6; <em>P</em> = .002), regardless of the dissected template. Both extended LND (HR 0.63; <em>P</em> = .004) and resection of ≥16 LNs (HR 0.66; <em>P</em> = .003) were associated with improved OS.</div></div><div><h3>Conclusion</h3><div>The number of LNs removed appears to be more important than the LN template in patients undergoing RC. Resection of at least 16 LNs is associated with better cancer control and oncologic outcome.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102337"},"PeriodicalIF":2.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943137","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":"Estimating the Impact of Adjuvant Treatment With Nivolumab on Long-Term Survivorship Rates Compared With Surveillance in Muscle Invasive Urothelial Carcinoma: Mixture Cure Modeling Analyses of Disease-Free Survival From the Phase 3 CheckMate 274 Trial","authors":"Daniel M. Geynisman ,&nbsp;Kateryna Chepynoga ,&nbsp;Georgia Yates ,&nbsp;Ashley Tate ,&nbsp;Murat Kurt ,&nbsp;Miraj Y. Patel ,&nbsp;Siguroli Teitsson ,&nbsp;Shreya Mitra ,&nbsp;Ronac Mamtani","doi":"10.1016/j.clgc.2025.102335","DOIUrl":"10.1016/j.clgc.2025.102335","url":null,"abstract":"<div><h3>Background</h3><div>Curative potential of adjuvant nivolumab was compared with radical resection only among patients at high risk of recurrence following radical surgery of muscle-invasive urothelial carcinoma (MIUC).</div></div><div><h3>Methods</h3><div>Using patient-level disease-free survival (DFS) data from CheckMate 274 (<em>n</em> = 709, minimum follow-up, 31.6 months), we applied mixture cure models (MCMs) to the adjuvant nivolumab (NIVO) and placebo (PBO) arms of the intention-to-treat (ITT) population and tumor PD-L1 expression ≥1% subpopulation. DFS was derived for hypothetical “cured” and “uncured” subgroups. DFS for the cured subgroup was estimated using WHO background mortality rates matched to trial demographic characteristics. Uncured DFS was modeled using parametric distributions and characterized with cure fractions by maximum-likelihood methods. Model selection considered clinical plausibility, visual comparisons of model fit, and goodness-of-fit statistics.</div></div><div><h3>Results</h3><div>MCM analysis demonstrated that almost all uncured patients experience recurrence or death within 5 years. Clinically plausible models estimated higher cure fractions in tumor PD-L1 ≥1% subgroup for patients treated with NIVO (PD-L1 ≥1%: 59.1%-61.0% vs ITT: 43.1%-45.1%), and highly similar cure fractions for patients receiving PBO irrespective of their PD-L1 expression (PD-L1 ≥1%: 35.9%-36.4% vs ITT: 36.4%-37.0%). Projected 10-year mean DFS was 4.38 to 4.47 years for NIVO and 3.61 to 3.64 years for PBO in the ITT population, and 5.54 to 5.65 years for NIVO and 3.54 to 3.57 years for PBO in the PD-L1 ≥1% subpopulation.</div></div><div><h3>Conclusions</h3><div>Adjuvant NIVO for high-risk MIUC was associated with a higher cure fraction than PBO in the ITT and PD-L1 ≥1% populations. Results align with reported survival from the trial and highlight clinical outcomes of interest. CheckMate 274 ClinicalTrials.gov identifier, NCT02632409.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102335"},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943136","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":"Characterization of Exceptional Responses in Patients With Metastatic Castration-Resistant Prostate Cancer Treated With Cabozantinib and Immune Checkpoint Inhibitors","authors":"Teja Ganta ,&nbsp;Jonathan F. Anker ,&nbsp;Eric Miller ,&nbsp;Himanshu Joshi ,&nbsp;Che-Kai Tsao ,&nbsp;William K. Oh","doi":"10.1016/j.clgc.2025.102336","DOIUrl":"10.1016/j.clgc.2025.102336","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Immune checkpoint inhibitors (ICIs) have been shown to have limited efficacy in unselected populations of patients with metastatic castration-resistant prostate cancer (mCRPC). In the phase III clinical trial CONTACT-02, a novel regimen combining cabozantinib and ICI improved progression-free survival in patients with mCRPC; however, due to its lack of survival benefit, it has not yet gained regulatory approval. In this retrospective series of patients with mCRPC without high tumor mutational burden or microsatellite instability treated with cabozantinib and ICI, the data indicate that a subpopulation exists with an exceptional long-term response, including some patients maintained on therapy for more than 30 months. The study further characterizes this subpopulation and can guide treatment selections for patients with limited options as oncologists and regulatory bodies continue to evaluate the risks and benefits of widespread adoption of this regimen.</div></span></li></ul></div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102336"},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820338","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":"Off-Label Use of First-Line Immunotherapy for Metastatic Renal Cell Carcinoma","authors":"Hannah D McManus ,&nbsp;Jessica B Long ,&nbsp;Sarah J Westvold ,&nbsp;Michael S Leapman ,&nbsp;Michael E Hurwitz ,&nbsp;Aaron P Mitchell ,&nbsp;Craig Evan Pollack ,&nbsp;Cary P Gross ,&nbsp;Michaela A Dinan","doi":"10.1016/j.clgc.2025.102330","DOIUrl":"10.1016/j.clgc.2025.102330","url":null,"abstract":"<div><h3>Introduction</h3><div>Immune checkpoint inhibitors (ICI) were approved by the Food and Drug Administration (FDA) for patients with metastatic renal cell carcinoma (mRCC) in the second- line setting in 2015 and the first-line (1L) in 2018. Little is known about 1 L ICI use in the off-label (before FDA indication-specific approval) and postapproval settings.</div></div><div><h3>Patients and Methods</h3><div>We retrospectively analyzed off-label and post-FDA-approval 1 L ICI receipt in a cohort of Medicare beneficiaries ≥66 years old diagnosed with mRCC from 2015 to 2019. Off-label and postapproval 1 L ICI were defined as before or on/after 4/16/2018 (1L ipilimumab/nivolumab approval). Associations between demographic characteristics and 1 L ICI receipt in the off-label and postapproval periods were examined using multivariable logistic regression.</div></div><div><h3>Results</h3><div>We identified 23,469 patients, of which 368 (2.4%) off-label and 1,663 (21%) postapproval received 1 L ICI. In the off-label period, patients with co-morbid conditions were more likely to receive 1 L ICI compared to patients with no co-morbidities (3+ conditions, OR = 2.00; 95% CL, 1.31-3.05). In the postapproval period, older patients were less likely to receive 1 L ICI (81+ vs. 66-70, OR = 0.60; 95% CL, 0.52-0.69), and patients who were frail were less likely to receive 1 L ICI (OR = 0.77; 95% CL, 0.69-0.87). There were not significant differences in 1 L ICI receipt based on race/ethnicity.</div></div><div><h3>Conclusion</h3><div>Older patients and patients with more comorbidities were more likely to receive 1 L ICI off-label, but these differences did not persist after FDA approval. After 1 L ipilimumab/nivolumab approval, patients receiving 1 L ICI were more likely younger, healthy, and receiving dual-ICI regimens.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102330"},"PeriodicalIF":2.3,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143769210","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":"Preliminary Assessment of Cone Beam CT Guided Percutaneous Cryoablation for CT1A Renal Cell Carcinoma: A Relatively Novel and Underutilized Technique","authors":"M. Duijn ,&nbsp;A.E.C. Ruiter ,&nbsp;A.D. Montauban van Swijndregt ,&nbsp;V.P.M. van der Hulst ,&nbsp;B.W. Lagerveld","doi":"10.1016/j.clgc.2025.102329","DOIUrl":"10.1016/j.clgc.2025.102329","url":null,"abstract":"<div><h3>Introduction</h3><div>To assess the efficacy and safety of cone beam CT guided percutaneous cryoablation (CBCT guided PCA) for the treatment of cT1a renal tumors by evaluating oncological outcomes and postoperative complication risk, in comparison to conventional CTguided PCA and laparoscopic cryoablation (LCA) using long-term follow-up data from a single-center cohort.</div></div><div><h3>Methods</h3><div>A retrospective analysis of 3 cryoablation (CA) techniques was conducted at our institution from December 2006 to February 2023. A total of 77 (32.6%) patients underwent CBCT guided PCA, 34 (14.4%) received CT guided PCA, and 125 (53%) were treated with LCA. Primary outcomes included recurrence-free survival (RFS) and overall complication rate (OCR). RFS was calculated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards analyses assessed the impact of specific baseline characteristics on recurrence risk.</div></div><div><h3>Results</h3><div>19 (8.1%) patients exhibited local disease recurrence during follow-up. Recurrence occurred in 7 (9.1%), 4 (11.8%), and 8 (6.4%) patients in the CBCT guided PCA, CT guided PCA, and LCA group, respectively (<em>P</em> = .549). The overall RFS was 90.1%, 88.2%, and 93.6% for CBCT guided PCA, CT guided PCA, and LCA, respectively. RFS did not differ significantly between the 3 groups (Log-rank for trend: <em>P</em> = .083). No significant difference in overall recurrence (OCR) was observed among the groups (<em>P</em> = .200).</div></div><div><h3>Conclusion</h3><div>CBCT guided PCA shows higher overall RFS in comparison to CT guided PCA and thereby is an effective and safe alternative for the treatment of small renal masses.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102329"},"PeriodicalIF":2.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial Differences in Survival for Locally Advanced Renal Cell Carcinoma","authors":"Jean-Pierre (Trey) Kanumuambidi ,&nbsp;Dmitry Tumin ,&nbsp;Michael Blute Jr.","doi":"10.1016/j.clgc.2025.102327","DOIUrl":"10.1016/j.clgc.2025.102327","url":null,"abstract":"<div><h3>Introduction</h3><div>African Americans with renal cell carcinoma (RCC) often have more aggressive tumors and worse outcomes compared to other racial groups. The impact of race on survival in locally advanced RCC with tumor thrombus and metastatic RCC (mRCC) remains unclear. This study evaluates racial disparities in survival among RCC patients with tumor thrombus.</div></div><div><h3>Methods</h3><div>This IRB-approved retrospective study analyzed 11,520 RCC patients aged 18 to 80 with tumor thrombus who underwent nephrectomy (2010-2015) using the National Cancer Database. Demographic factors (age, sex, race/ethnicity) and clinical variables (tumor stage, grade, thrombus level, surgery type, comorbidities) were included. Statistical analyses utilized Kaplan–Meier curves, Cox proportional hazards, and multinomial logistic regression, with significance set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>African Americans (6% of patients) had a 22% higher overall mortality hazard (HR: 1.22, <em>P</em> &lt; .001) and 24% higher hazard in metastatic RCC (HR: 1.24, <em>P</em> = .019) compared to non-Hispanic Whites (83%). Five-year survival rates for advanced thrombus levels (I–IV) were comparable between races. Overall mortality was 55%, rising to 82% in metastatic cases.</div></div><div><h3>Conclusion</h3><div>Among patients with RCC and tumor thrombus, African American patients face 22% higher mortality hazard compared to non-Hispanic white patients. They often present with more locally advanced disease and mRCC. The mortality hazard for metastatic RCC is increased by 24% among African Americans compared to Caucasians. The results highlight the demographic impact of race and supports clinical consideration when managing African American patients.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102327"},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774497","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 Initial Relative Dose Intensity on Tumor Response and Survival Outcomes in Enfortumab Vedotin Monotherapy for Previously Treated Advanced Urothelial Carcinoma: A Real-world Analysis From a Multicenter Study","authors":"Makito Miyake ,&nbsp;Nobutaka Nishimura ,&nbsp;Yusuke Iemura ,&nbsp;Motokiyo Yoshikawa ,&nbsp;Kazumasa Torimoto ,&nbsp;Atsushi Tomioka ,&nbsp;Keichi Sakamoto ,&nbsp;Yoshiaki Matsumura ,&nbsp;Makito Naoi ,&nbsp;Daiki Ichii ,&nbsp;Kuniaki Inoue ,&nbsp;Kosuke Narita ,&nbsp;Nobuo Oyama ,&nbsp;Mitsuru Tomizawa ,&nbsp;Takuto Shimizu ,&nbsp;Kenta Ohnishi ,&nbsp;Shunta Hori ,&nbsp;Yosuke Morizawa ,&nbsp;Daisuke Gotoh ,&nbsp;Yasushi Nakai ,&nbsp;Kiyohide Fujimoto","doi":"10.1016/j.clgc.2025.102326","DOIUrl":"10.1016/j.clgc.2025.102326","url":null,"abstract":"<div><h3>Objective</h3><div>To provide real-world evidence regarding the association between the initial relative dose intensity (RDI) of enfortumab vedotin (iRDI-EV) during the first 2 to 3 cycles for locally advanced or metastatic urothelial carcinoma (la/mUC) and patient characteristics, including EV-Ineligible criTeriA (EVITA), tumor response, and survival.</div></div><div><h3>Methods</h3><div>A multicenter database registered 83 patients with locally advanced or metastatic treated with late-line EV monotherapy between 2021 and 2023. The iRDI-EV was calculated based on the dose modification during the first 2 to 3 cycles. A dose of 1.25 mg/kg on days 1, 8, and 15 of a 28-day cycle was considered the standard full regimen. Patients were categorized into RDI-1 (lowest), RDI-2, RDI-3, and RDI-full (100% RDI) groups.</div></div><div><h3>Results</h3><div>In total, 68 patients were available for iRDI-EV analysis and response evaluation. The overall median iRDI-EV was 87%, with 14, 13, 13, and 28 patients in the 4 groups exhibiting median iRDI-EV of 62%, 73%, 83%, and 100%, respectively. No clear association between the iRDI-EV and objective response was observed. The disease control rate was significantly higher in the RDI-full group (96%) than in the other groups. The patients in higher RDI groups (RDI-3/RDI-full) had longer progression-free survival than the lower RDI groups (RDI-1/RDI-2), with no difference in overall survival. A multiple linear regression analysis revealed higher iRDI-EV was a strong contributor to better response and longer survival. Of the 83 patients, 4 met ≥2 EVITA, exhibiting a higher risk of progression, whereas 79 had EVITA ≤1.</div></div><div><h3>Conclusions</h3><div>Oncologists must continue to learn from real-world data on late-line EV monotherapy for combination therapy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102326"},"PeriodicalIF":2.3,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775239","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":"Pathological Complete Response in Metastatic Renal Cell Carcinoma Patients Treated With Cabozantinib Plus Nivolumab. Case Series and Literature Review","authors":"Marco Stellato MD ,&nbsp;Simone Rota MD ,&nbsp;Melanie Claps MD ,&nbsp;Valentina Guadalupi MD ,&nbsp;Alessandro Rametta MD ,&nbsp;Giuseppe Fotia MD ,&nbsp;Marco Barella MD ,&nbsp;Elena Verzoni MD ,&nbsp;Giuseppe Procopio MD","doi":"10.1016/j.clgc.2025.102328","DOIUrl":"10.1016/j.clgc.2025.102328","url":null,"abstract":"<div><div><ul><li><span>•</span><span><div>Cabozantinib plus nivolumab could be safe and effective in metastatic Renal Cell Carcinoma patients with oligometastatic disease and primary in site.</div></span></li><li><span>•</span><span><div>IO-TKI is associated to high response rate that sometimes includes pathological Complete Response.</div></span></li><li><span>•</span><span><div>Cytoreductive Nephrectomy should be considered in multidisciplinary team as an option for selected patients with low disease burden, fit for surgery, especially following a favorable response to systemic treatment.</div></span></li></ul></div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102328"},"PeriodicalIF":2.3,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143714236","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":"Geographic Distribution of Racial Differences in Renal Cell Carcinoma Mortality","authors":"Xiaoxian Liu ,&nbsp;Chengqian Shi ,&nbsp;Bin Han ,&nbsp;Jie Yang","doi":"10.1016/j.clgc.2025.102324","DOIUrl":"10.1016/j.clgc.2025.102324","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the geographic variations in Renal cell carcinoma (RCC) -specific death disparities from competing causes among Hispanic, non-Hispanic White, non-Hispanic Black, and Asian/Pacific Islander RCC patients. RCC outcomes in specific racial/ethnic population warrants further research and it is unknown whether racial/ethnic differences in RCC survival vary geographically within the US.</div></div><div><h3>Methods</h3><div>This retrospective cohort study was conducted to assess all RCC patients from 2014 to 2021. Data was extracted from the Surveillance, Epidemiology, and End Results (SEER) database. The primary outcome was RCC-related mortality.</div></div><div><h3>Results</h3><div>The study included 85,975 patients with RCC from 16 geographic areas within the SEER database. Kaplan–Meier analysis showed that Hispanic patients had the worst survival outcome (<em>P</em> &lt; .001 by log rank test). In the multivariable competing-risks regression, Hispanics had a higher risk of cancer-specific mortality (hazard ratio [HR] 1.29, 95% CI, 1.20-1.38, <em>P</em> ˂ .001) compared with non-Hispanic Whites. The increase in the risk of RCC-related death with Hispanic race/ethnicity was consistent across all major subgroups stratified by the covariables. In stratified analyses of geographic regions, there were 3 areas in which Hispanics had worse RCC-specific survival (Los Angeles: HR 1.22, 95% CI, 1.06-1.41, <em>P</em> = .005; Greater California: HR 1.125, 95% CI, 1.15-1.37, <em>P</em> &lt; .001; Atlanta, Georgia: HR 1.95, 95% CI, 1.32-2.88, <em>P</em> = .001).</div></div><div><h3>Conclusion</h3><div>These results demonstrate that population-level variations in RCC survival among Hispanics and non-Hispanic Whites were associated with a small number of geographic regions. Targeted interventions in these regions may be conducive to alleviating RCC care differences at the national level.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102324"},"PeriodicalIF":2.3,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743880","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":"Effectiveness of the Continuous Care Model on Quality of Life, Sexual Satisfaction and Function in Bladder Cancer Patients Undergoing Tumor Resection Surgery: A Randomized Control Trial","authors":"Fateme Rezaeeniya ,&nbsp;Fateme Hasandoost ,&nbsp;Amir Reza Abedi ,&nbsp;Alireza Amanollahi ,&nbsp;Soolmaz Moosavi","doi":"10.1016/j.clgc.2025.102321","DOIUrl":"10.1016/j.clgc.2025.102321","url":null,"abstract":"<div><h3>Background</h3><div>Bladder cancer is a global health concern, and while surgery is vital, it often diminishes patient quality of life, notably sexual function. Existing self-care education is insufficient, necessitating a more holistic approach. The Continuous Care Model (CCM), which emphasizes patient empowerment, shows promise. This study investigates a CCM intervention that includes sexual health education to improve quality of life (QoL) and sexual satisfaction in bladder cancer patients.</div></div><div><h3>Methods</h3><div>This randomized controlled trial enrolled 54 bladder cancer patients undergoing tumor resection surgery in Tehran, Iran (April-September 2024). Participants were randomly assigned to either a CCM intervention group (n = 26) and a control group (n = 28). QoL was assessed using the EORTC QLQ-C30; sexual function and satisfaction were measured using the Larson Sexual Satisfaction Questionnaire, IIEF, and FSFI at baseline and at 1 and 3 months postintervention.</div></div><div><h3>Results</h3><div>The CCM group demonstrated significantly improved overall QoL (<em>P</em> &lt; .001) and several subscales (physical, emotional, cognitive, fatigue) compared to controls. Sexual satisfaction also improved significantly in the CCM group (<em>P</em> &lt; .001). Sexual function enhanced particularly for males (enhanced orgasm and sexual desire, <em>P</em> = .049, <em>P</em> = .020, respectively). No significant changes in female sexual function were observed, although past medical history (<em>P</em> = .019) and partner's job (<em>P</em> = .017) were significantly associated with female sexual function.</div></div><div><h3>Conclusions</h3><div>The CCM intervention effectively enhanced QoL, sexual satisfaction, and sexual function particularly in males. Further research is needed to address the unique challenges impacting female patients' sexual function postbladder cancer surgery<strong>.</strong></div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102321"},"PeriodicalIF":2.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775234","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}