Clinical genitourinary cancer最新文献

{"title":"Optimal Cystoscopic Surveillance Schedule Following Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma","authors":"Yuhei Koike ,&nbsp;Fumihiko Urabe ,&nbsp;Katsuki Muramoto ,&nbsp;Yuma Goto ,&nbsp;Kosuke Iwatani ,&nbsp;Yu Imai ,&nbsp;Mahito Atsuta ,&nbsp;Keiji Yasue ,&nbsp;Keiichiro Mori ,&nbsp;Hajime Onuma ,&nbsp;Koichi Aikawa ,&nbsp;Kojiro Tashiro ,&nbsp;Jeremy Teoh ,&nbsp;Brendan A. Yanada ,&nbsp;Shunsuke Tsuzuki ,&nbsp;Toshihiro Yamamoto ,&nbsp;Akira Furuta ,&nbsp;Hiroki Yamada ,&nbsp;Jun Miki ,&nbsp;Takahiro Kimura","doi":"10.1016/j.clgc.2025.102354","DOIUrl":"10.1016/j.clgc.2025.102354","url":null,"abstract":"<div><h3>Background</h3><div>Upper tract urothelial carcinoma (UTUC) has shown an increasing incidence, with intravesical recurrence (IVR) being a common postoperative challenge following radical nephroureterectomy. Although current guidelines recommend cystoscopic surveillance based on risk stratification, these recommendations are weak and may not adequately address IVR-specific risk factors or optimal surveillance intervals.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 700 patients who underwent radical nephroureterectomy between 2012 and 2021. Risk factors for IVR were identified using Cox proportional hazards regression models, and optimal cystoscopic intervals were evaluated through hypothetical surveillance models. Gap risk ratios were calculated to assess the risk of delayed IVR detection, stratified by the presence or absence of identified risk factors.</div></div><div><h3>Results</h3><div>The median follow-up duration was 28 months, and IVR occurred in 38.0% of patients. Significant risk factors included a history of bladder cancer, positive voided cytology, and preoperative ureteroscopy. Kaplan–Meier curves revealed significantly worse IVR-free survival in patients with 1 or more risk factors (<em>P</em> &lt; .001). Gap risk ratio analysis supported frequent surveillance during the first postoperative year, with tailored intervals thereafter. For patients without risk factors, surveillance every 3 months during the first year, every 6 months during the second year, and annually thereafter was optimal. For patients with risk factors, surveillance every 3 months during the first year, every 6 months for the next 2 years, and annually thereafter was recommended.</div></div><div><h3>Conclusion</h3><div>Tailored cystoscopic surveillance schedules based on IVR risk factors optimize recurrence detection while minimizing procedural burden. These findings provide an evidence-based framework for individualized surveillance strategies in patients with UTUC following nephroureterectomy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102354"},"PeriodicalIF":2.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994197","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":"Critical Appraisal of the TRANSLATE Trial","authors":"Caio Suartz","doi":"10.1016/j.clgc.2025.102355","DOIUrl":"10.1016/j.clgc.2025.102355","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 4","pages":"Article 102355"},"PeriodicalIF":2.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948107","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":"Efficacy of Neoadjuvant Hormonal Therapy for High-Risk Prostate Cancer Undergoing Robot-Assisted Radical Prostatectomy: A Retrospective Multicenter Study Using Propensity Score-Matched Analysis in Japan","authors":"Minori Nezasa ,&nbsp;Makoto Kawase ,&nbsp;Satoshi Washino ,&nbsp;Takato Nishino ,&nbsp;Hajime Fukushima ,&nbsp;Kosuke Iwatani ,&nbsp;Tomoaki Miyagawa ,&nbsp;Masaki Shimbo ,&nbsp;Takeshi Yamasaki ,&nbsp;Kojiro Ohba ,&nbsp;Jun Miki ,&nbsp;Kenichiro Ishida ,&nbsp;Takuya Koie","doi":"10.1016/j.clgc.2025.102346","DOIUrl":"10.1016/j.clgc.2025.102346","url":null,"abstract":"<div><h3>Introduction</h3><div>The potential improvement in oncological outcomes of robot-assisted radical prostatectomy (RARP) with neoadjuvant androgen deprivation therapy (ADT) in patients with prostate cancer (PCa) who had high-risk or very-high risk disease (HR/VHR-PCa) remains controversial. This study evaluated the impact of neoadjuvant hormone therapy (NHT) on biochemical recurrence (BCR) following RARP.</div></div><div><h3>Materials and Methods</h3><div>A total of 1,203 patients with HR/VHR-PCa who underwent RARP at 6 centers in Japan were included. Patients were categorized into 2 groups: those who underwent RARP alone (RARP-alone group) and those who underwent RARP following NHT (NHT group). The primary endpoint was biochemical recurrence-free survival (BRFS) after RARP.</div></div><div><h3>Results</h3><div>A total of 976 patients were analyzed, including 140 patients in each group after propensity score matching. At a median follow-up of 47 months, BCR was observed in 40.7% of patients in the RARP-alone group and 31.4% in the NHT group (<em>P</em> = .106). BRFS rates did not significantly differ between the 2 groups (<em>P</em> = .671). The RARP-alone group tended to have slightly longer operative times and more positive surgical margins than the NHT group.</div></div><div><h3>Conclusion</h3><div>This study suggests that NHT does not improve BRFS in patients with HR/VHR-PCa undergoing RARP. Further research is necessary to develop more effective neoadjuvant regimens for this patient population.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102346"},"PeriodicalIF":2.3,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886458","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":"Optimal Timing of Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma Patients Considering Sarcomatoid Status: A Real-World Study","authors":"Ghady Bou-Nehme Sawaya ,&nbsp;Simon Tanguay ,&nbsp;Lori A. Wood ,&nbsp;Christian Kollmannsberger ,&nbsp;Naveen S. Basappa ,&nbsp;Rahul Bansal ,&nbsp;Denis Soulières ,&nbsp;Antonio Finelli ,&nbsp;Daniel Y.C. Heng ,&nbsp;Vincent Castonguay ,&nbsp;Christina Canil ,&nbsp;Eric Winquist ,&nbsp;Jeffrey Graham ,&nbsp;Georg A. Bjarnason ,&nbsp;Bimal Bhindi ,&nbsp;Aly-Khan Lalani ,&nbsp;Frédéric Pouliot ,&nbsp;Rodney H. Breau ,&nbsp;Ramy Saleh ,&nbsp;Alice Dragomir","doi":"10.1016/j.clgc.2025.102342","DOIUrl":"10.1016/j.clgc.2025.102342","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the outcomes of metastatic renal cell carcinoma (mRCC) patients, with or without sarcomatoid features, who underwent cytoreductive nephrectomy (CN) before or after systemic therapies (ST).</div></div><div><h3>Methods</h3><div>Synchronous metastatic RCC patients of IMDC intermediate- and high-risk diagnosed between January 2011 to December 2022, treated with CN before or after ST, and with histological documentation of the presence or absence of sarcomatoid features in nephrectomy specimens were identified using the Canadian Kidney Cancer information system (CKCis). Patients were classified by treatment sequence received: (1) CN after ST (2) CN before ST. Inverse probability of treatment weighting using propensity scores was used to balance for covariates. Cox proportional hazards models were used to assess the impact of initial treatment received on overall survival (OS).</div></div><div><h3>Results</h3><div>Of 709 eligible patients, 105 were treated with CN after ST and 604 with CN before ST. 75% were male, and the majority (70%) received targeted therapies (TT) used alone. In nonsarcomatoid patients (80 CN after ST and 454 CN before ST), treatment with CN after ST was associated with an improvement in OS, that was not statistically significant, compared to CN before ST (median of 60 vs. 48 months, HR 0.84, 95% CI 0.64-1.11). In sarcomatoid patients (25 CN after ST and 150 CN before ST), CN after ST was also not associated with better survival (median of 24 vs. 36 months, HR 1.10, 95% CI 0.70-1.73).</div></div><div><h3>Conclusion</h3><div>In conclusion, this study demonstrated that, no matter the sarcomatoid status, there is no statistical difference between receiving CN after ST or CN before ST. The timing of CN could potentially be linked more so to clinical assessments than the knowledge of sarcomatoid status.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102342"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874464","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":"Propensity Score-Matched Analysis of Radical and Partial Nephrectomy in pT3aN0M0 Renal Cell Carcinoma","authors":"Cesare Saitta ,&nbsp;Riccardo Autorino ,&nbsp;Umberto Capitanio ,&nbsp;Giovanni Lughezzani ,&nbsp;Margaret F. Meagher ,&nbsp;Kendrick Yim ,&nbsp;Mimi V. Nguyen ,&nbsp;Matilde Mantovani ,&nbsp;Melis Guer ,&nbsp;Daniele Amparore ,&nbsp;Federico Piramide ,&nbsp;Kevin Hakimi ,&nbsp;Dattatraya Patil ,&nbsp;Hajime Tanaka ,&nbsp;Shohei Fukuda ,&nbsp;Masaki Kobayashi ,&nbsp;Wei Chen ,&nbsp;Savio D. Pandolfo ,&nbsp;Julian Cortes ,&nbsp;Dhruv Puri ,&nbsp;Ithaar H. Derweesh","doi":"10.1016/j.clgc.2025.102343","DOIUrl":"10.1016/j.clgc.2025.102343","url":null,"abstract":"<div><h3>Background</h3><div>We sought to evaluate oncological and functional outcomes of patients treated with partial nephrectomy (PN) and radical nephrectomy (RN) in pT3aN0M0 renal cell carcinoma (RCC).</div></div><div><h3>Patients and Methods</h3><div>We conducted a retrospective analysis of surgically treated pT3aN0M0 RCC patients. Primary outcome was all-cause mortality/overall survival (ACM/OS). Secondary outcomes were cancer-specific mortality/ cancer-specific survival (CSM/CSS), recurrence/progression free survival (PFS) and new onset de novo eGFR &lt; 45 mL/min/1.73 m² (CKD-S3b). A propensity score matched model in a 1:1 ratio was conducted, within a caliper width of 0.01. Kaplan–Meier analysis (KMA) and Cox multivariable analysis (MVA) were fitted to delineate survival outcomes and their predictors.</div></div><div><h3>Results</h3><div>After PSM 359 were analyzed (PN = 179 vs. RN = 180); median follow up of 38.7 (IQR 16.28-64) months. MVA for ACM revealed, high grade (HR 2.05, <em>P</em> = .019), and CKD-S3b at last follow up (HR 2.13, <em>P</em> = .018) as independent risk factors, while RN versus PN (<em>P</em> = .41) was not. MVA for CSM and recurrence revealed that RN versus PN was not an independent risk factor for CSM (<em>P</em> = .088) and recurrence (<em>P</em> = .277). MVA for CKD-S3b revealed RN versus PN (HR 1.67 <em>P</em> = .025) as associated with increased risk of CKD-S3b. KMA comparing PN versus RN revealed 5-year OS of 87.4% versus 82% (<em>P</em> = .26); 5-year CSS of 95.6% versus 90.3% (<em>P</em> = .15); 5-year PFS of 83.5% versus 77% (<em>P</em> = .38); 5-year CKD-S3b free survival of 80.8% versus 65.5% (<em>P</em> = .016).</div></div><div><h3>Conclusion</h3><div>PN exhibited oncological equipoise while reducing risk of development of eGFR &lt; 45 mL/min/1.73 m². PN may be considered in T3a RCC when prioritization of functional preservation is indicated.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102343"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870809","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":"Disease Monitoring and Treatment Patterns of von Hippel-Lindau Disease-Associated Renal Cell Carcinoma in the United States","authors":"Eric Jonasch ,&nbsp;Yan Song ,&nbsp;Jonathan Freimark ,&nbsp;Manasi Mohan ,&nbsp;James Signorovitch ,&nbsp;Murali Sundaram","doi":"10.1016/j.clgc.2025.102349","DOIUrl":"10.1016/j.clgc.2025.102349","url":null,"abstract":"<div><h3>Background</h3><div>Patients with von Hippel-Lindau (VHL) disease are predisposed to lifelong risk of tumors in multiple organs. This study evaluated disease monitoring and treatment patterns among patients with VHL-associated renal cell carcinoma (VHL-RCC).</div></div><div><h3>Patients and Methods</h3><div>Using an algorithm based on VHL manifestations, patients with VHL-RCC were selected from Optum’s de-identified Clinformatics Data Mart Database (2007-2020) and matched to controls without VHL or RCC. Treatment patterns for VHL-associated tumors were described. Incidence rate ratios (IRRs) for pain management drug use, disease monitoring procedures, and medical specialist visits in the patient versus control cohorts were estimated using generalized linear models.</div></div><div><h3>Results</h3><div>Among 160 patients with VHL-RCC and 800 matched controls (mean age 51.5 years; 44.4% female), the most commonly observed tumor treatments during the study period were nephrectomy and targeted therapies for RCC (incidence rates: 2.13 and 2.07 per 10-person years, respectively); a small but notable portion of patients also received tumor treatments for other VHL-associated tumors (incidence rates: 0.07-0.37 per 10-person years). Kaplan-Meier–estimated median time to first RCC tumor treatment from initial observed RCC diagnosis was 48 days. The patient cohort had greater paint management drug use (adjusted IRR: 1.37 [95% CI: 0.97, 1.94]), received more disease monitoring procedures (3.97 [95% CI: 3.42, 4.61]), and visited more medical specialists (1.82 [95% CI: 0.94, 3.50]-26.51 [95% CI: 5.29, 132.77]) than the control cohort.</div></div><div><h3>Conclusion</h3><div>The burden of VHL-RCC extends beyond surgical excision to various treatments for managing VHL-associated tumors. Effective tumor control may mitigate the burden of morbidity of VHL-RCC.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102349"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943147","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":"PSMA-Targeted Biopsy With Fusion Guidance for Detecting Clinically Significant Prostate Cancer in Men With Negative MRI-Feasibility and Diagnostic Performance of a Pilot Single-Center Prospective Study","authors":"Lorenzo Bianchi ,&nbsp;Danilo Cangemi ,&nbsp;Andrea Farolfi ,&nbsp;Caterina Maria Paola Sgro ,&nbsp;Andrea Di Giorgio ,&nbsp;Paolo Castellucci ,&nbsp;Caterina Gaudiano ,&nbsp;Beniamino Corcioni ,&nbsp;Francesca Giunchi ,&nbsp;Alessio Degiovanni ,&nbsp;Valerio Pirelli ,&nbsp;Chiara Mignogna ,&nbsp;Valeria Rotaru ,&nbsp;Angelo Mottaran ,&nbsp;Pietro Piazza ,&nbsp;Matteo Droghetti ,&nbsp;Matteo Ragni ,&nbsp;Francesco Romei ,&nbsp;Cristina Mosconi ,&nbsp;Michelangelo Fiorentino ,&nbsp;Eugenio Brunocilla","doi":"10.1016/j.clgc.2025.102348","DOIUrl":"10.1016/j.clgc.2025.102348","url":null,"abstract":"<div><h3>Introduction</h3><div>Contemporary prostate biopsy utilizes multiparametric magnetic resonance (MRI) guidance; however, it may fail to identify a non-negligible proportion of men with clinically significant (csPCa). The main objective of this study was to assess the feasibility and diagnostic performance of Prostate Specific Membrane Antigen-Target biopsy (PSMA-TB) to diagnose csPCa in men with negative MRI and high clinical risk of PCa.</div></div><div><h3>Patients and Methods</h3><div>Open-label, single-center, nonrandomized, prospective study. Inclusion criteria: PSA density (PSAd) ≥0.2 ng/ml² in men with PIRADS 1-2; PSA &gt;10 ng/ml or abnormal digital rectal examination or strong familiar history for PCa or known genetic mutation. Each patients underwent PSMA-PET and transperineal fusion PSMA-TB ± systematic biopsy (SB).</div></div><div><h3>Results</h3><div>Overall, 35 patients were enrolled; 23 (65.7%) men had positive PSMA-PET (PRIMARY score ≥3). Overall, 14 (40%) men had csPCA and 21 (60%) patients had any PCa at PSMA-TB+SB. Only 1 patient (8.3%) with negative PSMA-PET had csPCa (ISUP 3) at SB (92% Negative Predictive Value [NPV]). Fusion PSMA-TB alone detected csPCa in 12 out of 23 (52.2%) patients with positive PSMA-PET; fusion PSMA-TB with concomitant SB increased the detection of csPCa to 56.5% (added value of 4.3%). The sensitivity, specificity, Positive Predictive Value (PPV), NPV and AUC of PSMA-TB+SB were 93%, 57%, 59%, 92% and 0.75 for detection of csPCa and 91%, 79%, 86%, 95% and 0.84 for detection of any PCa, respectively. The main limitation of this study is its small sample size.</div></div><div><h3>Conclusions</h3><div>Fusion PSMA-TB is technically feasible and may improve the detection of csPCa in patients with negative MRI.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102348"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943146","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":"Prostate Cancer Screening: Empirical Clinical Practice, Not Evidence-Based","authors":"Takeshi Takahashi","doi":"10.1016/j.clgc.2025.102341","DOIUrl":"10.1016/j.clgc.2025.102341","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102341"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870810","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 and outcomes for younger patients with metastatic castration-resistant prostate cancer (mCRPC); An Australian prospective registry study","authors":"Colin Williams ,&nbsp;Andrisha-Jade Inderjeeth ,&nbsp;Wei Hong ,&nbsp;Jane McKenzie ,&nbsp;Angelyn Anton ,&nbsp;Andrew Weickhardt ,&nbsp;Shirley Wong ,&nbsp;Jeremy Shapiro ,&nbsp;Phillip Parente ,&nbsp;Jeffrey Goh ,&nbsp;Javier Torres ,&nbsp;Annabel Smith ,&nbsp;Anthony Joshua ,&nbsp;Stephen Brown ,&nbsp;Christopher Steer ,&nbsp;Julie Johns ,&nbsp;Peter Gibbs ,&nbsp;Ben Tran ,&nbsp;Arun A. Azad","doi":"10.1016/j.clgc.2025.102345","DOIUrl":"10.1016/j.clgc.2025.102345","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>There is an increasing incidence of cancer in younger patients, including prostate cancer.</div><div>Cancers developing in younger patients are reported to have a more aggressive phenotype. There is a need to examine younger patients with metastatic castration-resistant prostate cancer (mCRPC).</div></div><div><h3>Methods</h3><div>Analysis of the prospectively collected, multisite, electronic Prostate Cancer Australian Database (ePAD) was conducted to identify all mCRPC patients enrolled between June 2016 and March 2024. We defined patients diagnosed aged &lt; 55 years as younger patients (YP) and compared their characteristics, treatment patterns and outcomes to the other patients aged ≥ 55 years (OP).</div></div><div><h3>Results</h3><div>Of 915 patients with mCRPC, 59 (6%) were YP. De-novo metastatic presentation, Gleason score, presence of liver metastasis and PSA doubling time at mCRPC were similar between YP and OP. In the mCRPC setting, first line treatment with docetaxel (19% YP vs. 21% OP; <em>P</em> = .72) and ARPI (68% YP vs. 74% OP; <em>P</em> = .31) was also similar. YP were more likely to receive ≥ 3 lines of therapy for mCRPC (37% YP vs. 23% OP; <em>P</em> = .016). There was no significant difference in overall survival from start of first line therapy (median 41.9 m YP vs. 35.1 m OP; HR 0.73; 95% CI, 0.47-1.15; <em>P</em> = .17) or time-to-treatment discontinuation for ARPI (median 15.8 m YP vs. 14.9 m OP; HR 0.93; 95% CI, 0.61-1.42; <em>P</em> = .75). Age &lt; 55 was not independently associated with survival on multivariable analysis (HR 0.82; 95% CI, 0.52-1.29; <em>P</em> = .38).</div></div><div><h3>Conclusion</h3><div>Young patients with prostate cancer who go on to develop mCRPC do not appear to have distinct clinical outcomes to other patients.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102345"},"PeriodicalIF":2.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143899325","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":"Incidence of Bladder Cancer, Healthcare Pathways, and Economic Burden: A Real-World Observational Study From the French National Healthcare System Database","authors":"Aldéric Masoandro Fraslin ,&nbsp;Simone Benhamou ,&nbsp;Thierry Lebret ,&nbsp;François Radvanyi ,&nbsp;Yves Allory ,&nbsp;Maryam Karimi ,&nbsp;Julia Bonastre","doi":"10.1016/j.clgc.2025.102344","DOIUrl":"10.1016/j.clgc.2025.102344","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the incidence (all lesions) of bladder cancer (BC) in France, describe patient characteristics and healthcare pathways during the first year after diagnosis, and estimate medical costs.</div></div><div><h3>Methods</h3><div>All adult patients with an initial BC diagnosis (ICD-10 codes: C67, D09.0, D41.4) in 2017 were selected from the French National Healthcare System Database. Patients were classified according to the most invasive surgical procedure they underwent. Treatments included cystectomy, transurethral resection of bladder tumor (TURBT), intravesical therapy, chemotherapy, and radiotherapy. Healthcare pathways were analyzed as sequences and grouped using hierarchical clustering. Medical costs during the first year of the disease were estimated for each cluster.</div></div><div><h3>Results</h3><div>Out of 24,737 incident BC patients selected, the median age at diagnosis was 72 years, and 80.2% were men. Nearly 20% had received treatment for a cancer other than BC in the previous year. The majority (<em>n</em> = 9501, 38.4%) underwent TURBT only with a mean medical cost of €4435 [95% CI: 4322; 4548]. A total of 3037 patients (12.3%) underwent cystectomy as their initial treatment. The estimated costs for the group receiving intravesical instillations following a single TURBT (€6129 [5994; 6264]) were lower than those for the group with repeated TURBT (€9357 [9086; 9628]). Costs for patients who received systemic treatment after cystectomy were the highest at €25,636 [24,519; 26,752].</div></div><div><h3>Conclusion</h3><div>Our study estimates the incidence of BC in France, describes healthcare pathways at the national level, and analyses the associated economic burden.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 3","pages":"Article 102344"},"PeriodicalIF":2.3,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870811","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}