Clinical genitourinary cancer最新文献

{"title":"The Impact of Computed Tomography-Defined Sarcopenia on Surgical Outcomes in Patients with Sarcomatoid Renal Cell Carcinoma: A Comprehensive Assessment of Abdominal, Psoas, and Paraspinal Musculature","authors":"Tongpeng Liu ,&nbsp;Zhijian Zhou ,&nbsp;Yu Yao ,&nbsp;Yang Hu ,&nbsp;Lijiang Sun ,&nbsp;Guiming Zhang","doi":"10.1016/j.clgc.2025.102434","DOIUrl":"10.1016/j.clgc.2025.102434","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to evaluate the prognostic impact of computed tomography (CT)-defined sarcopenia, assessed via different muscle groups (total abdominal muscle [TAM], psoas muscle [PM], and paraspinal muscle [PS]), on outcomes in patients with sarcomatoid renal cell carcinoma (SRCC) undergoing surgical treatment.</div></div><div><h3>Patients and Methods</h3><div>A retrospective cohort of 125 pathologically confirmed SRCC patients (2009-2024) was analyzed. Sarcopenia was defined using sex-specific cut-offs for height-adjusted TAM and PM indices, and absolute PS area at the third lumbar vertebra on preoperative CT. The primary endpoint was overall survival (OS). Statistical analyses included Kaplan-Meier curves, Cox regression, LASSO selection, and bootstrap-validated nomogram construction.</div></div><div><h3>Results</h3><div>Multivariable analysis identified PS-defined sarcopenia as an independent predictor of worse OS (HR = 2.74, 95% CI, 1.001-7.481, <em>P</em> &lt; .05), while TAM- and PM-defined sarcopenia lacked independent prognostic value. Subgroup analysis revealed significant prognostic association of PS-sarcopenia only in male patients. A nomogram incorporating tumor size, N stage, M stage, platelet-neutrophil ratio, platelet-albumin ratio, and PS-sarcopenia demonstrated good predictive accuracy for 1-, 2-, and 3-year OS (AUCs: 0.807, 0.760, 0.781), with a bootstrap-corrected C-index of 0.750.</div></div><div><h3>Conclusion</h3><div>CT-quantified paraspinal muscle mass is an independent prognostic factor for OS in SRCC patients after surgery, particularly in males, and may serve as a valuable biomarker for risk stratification. A nomogram incorporating PS-sarcopenia shows promising predictive performance for individualized prognosis.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102434"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245922","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":"Discovery of TBK1-Associated Oncogenic Mechanisms in Patients With Upper Tract Urothelial Carcinoma and Pre-Existing End-Stage Renal Disease","authors":"Yu-Pin Huang ,&nbsp;Jen-Chieh Chen ,&nbsp;Yu-Ching Peng ,&nbsp;Yu-Kuang Chen ,&nbsp;William J. Huang ,&nbsp;Cih-Yu Jheng ,&nbsp;Yi-Ting Liao ,&nbsp;Eric Yi-Hsiu Huang ,&nbsp;Kung-Hao Liang","doi":"10.1016/j.clgc.2025.102420","DOIUrl":"10.1016/j.clgc.2025.102420","url":null,"abstract":"<div><h3>Background</h3><div>Upper tract urothelial carcinoma is an aggressive malignancy originating from the transitional epithelium of the urinary tract. UTUC patients with pre-existing end stage renal disease (ESRD) have limited perioperative treatment options due to severely impaired bilateral kidney functions. We therefore sought to identify targetable oncogenic mechanisms in this patient population.</div></div><div><h3>Methods</h3><div>A single-center retrospective study analyzed 50 fresh frozen UTUC tumor samples (17 with ESRD, 33 without) using RNA sequencing for transcriptomics profiling. Gene set enrichment analysis was performed to identify gene sets collectively enriched in ESRD tumors, with normalized enrichment score (NES) used to standardize enrichment magnitude across sets of varying sizes. Regular hemodialysis prior to UTUC diagnosis was used to identify patients with ESRD. Immunohistochemical staining was conducted on paraffin-embedded slides (6 with ESRD, 7 without) to demonstrate the involvement of representative proteins in the gene set. Candidate drugs were ranked via Connectivity Map analysis, and the drug with the highest inhibition score were further assessed through <em>in vitro</em> cell viability and migration assays.</div></div><div><h3>Results</h3><div>Because overall and cancer‑specific survival did not differ significantly between groups, we interpreted transcriptomic differences as intrinsic tumor characteristics rather than consequences of disease severity. TBK1-associated gene sets were enriched in ESRD-UTUC patients (NES = 2.065, FDR q value = 0.001). Immunohistochemistry confirmed higher TBK1 levels in ESRD tissues (<em>P</em> = .044). A IKK/NF-κB inhibitor, Withaferin A (CAS No. 5119-48-2), emerged as a leading candidate drug (score of inhibition = 2.521). The <em>in vitro</em> assays demonstrated the effectiveness of Withaferin A in reducing the viability and migration of UTUC cells, suggesting potential for further clinical investigation.</div></div><div><h3>Conclusions</h3><div>The TBK1-associated oncogenic mechanism is prominent in UTUC patients with preexisting ESRD. Withaferin A demonstrates preclinical promise as a therapeutic candidate targeting this mechanism in UTUC patients with compromised renal function.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102420"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066426","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":"Subcentimeter Pulmonary Nodules in Patients With Clinical Stage I Non-Seminoma: Impact on Risk and Patterns of Disease Relapse","authors":"Adri M. Durant ,&nbsp;Kshitij Pandit ,&nbsp;Nadia Islam ,&nbsp;Mimi Nguyen ,&nbsp;Margaret Meagher ,&nbsp;Mai Dabbas ,&nbsp;Lanyu Mi ,&nbsp;Timothy D. Lyon ,&nbsp;Fred Millard ,&nbsp;Stephen A. Boorjian ,&nbsp;Bradley Leibovich ,&nbsp;Mark D. Tyson ,&nbsp;Aditya Bagrodia","doi":"10.1016/j.clgc.2025.102448","DOIUrl":"10.1016/j.clgc.2025.102448","url":null,"abstract":"<div><h3>Introduction</h3><div>Indeterminate subcentimeter pulmonary nodules identified during the initial staging of patients with clinical stage I non-seminoma germ cell tumor (NSGCT) remain of uncertain clinical significance and yet can increase patient anxiety and cloud management decisions. We seek to evaluate the incidence and risk of disease recurrence in stage I NSGCT patients with subcentimeter pulmonary nodules.</div></div><div><h3>Methods</h3><div>Patients with clinical stage I NSGCT receiving an orchiectomy from 2003 to 2024 with at least 3-months of follow-up were identified (<em>n</em> = 215). Patient demographics, pathologic characteristics, administration of adjuvant therapy, and disease relapse data were collected. Initial staging imaging reports were reviewed identifying patients with SPN (&lt; 1cm). The relationship between SPN and disease recurrence was investigated.</div></div><div><h3>Results</h3><div>We identified 215 patients with stage I NSGCT, of whom 71 (33.0%) had SPN on initial staging imaging. A total of 52 patients (24.2%) received adjuvant treatment (primary RPLND 31 patients, primary chemotherapy 21 patients), with no significant difference in therapy between patients with and without SPN (<em>P</em> = .09). At a median follow-up of 22-months, disease recurrence occurred in 51 (23.7%) patients. The presence of SPN was not associated with increased risk of disease recurrence on univariate analysis (<em>P</em> = .12) and was associated with a decreased risk of recurrence on multivariable analysis (OR (95% CI): 0.38 (0.17, 0.83); <em>P</em> = .02). Of 6 patients who progressed to metastatic lung disease, only 1 patient had SPN at the time of presentation.</div></div><div><h3>Conclusion</h3><div>Our study suggests that SPN in stage I NSGCT are not associated with an increased risk of disease relapse. These findings may be used in patient counseling and to avoid overtreatment in management decisions.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102448"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358547","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 Hemoglobin A1c on the Obesity Paradox and Survival in Patients With Non-Metastatic Renal Cell Carcinoma","authors":"Alexander Abdollahzadeh ,&nbsp;Reza Lahiji ,&nbsp;Ernest Allen Morton ,&nbsp;Lorenzo Storino Ramacciotti ,&nbsp;Adam Braunschweig ,&nbsp;Dattatraya Patil ,&nbsp;Valentina Grajales ,&nbsp;Shreyas S. Joshi ,&nbsp;Vikram M. Narayan ,&nbsp;Reza Nabavizadeh ,&nbsp;Mohammad Hajiha ,&nbsp;Kenneth Ogan ,&nbsp;Viraj A. Master","doi":"10.1016/j.clgc.2025.102457","DOIUrl":"10.1016/j.clgc.2025.102457","url":null,"abstract":"<div><h3>Introduction</h3><div>The “obesity paradox” suggests that patients with various cancers, including renal cell carcinoma (RCC), and body mass index (BMI) ≥ 30 kg/m² may experience improved survival. However, the influence of glycemic control on this association remains unclear. This study evaluates whether elevated hemoglobin A1c (HbA1c) modifies the survival benefit associated with the obesity paradox in patients undergoing nephrectomy for non-metastatic RCC.</div></div><div><h3>Methods</h3><div>Patients undergoing nephrectomy for non-metastatic RCC at a single academic center from 2005 to 2024 were screened for inclusion. Inclusion criteria included HbA1c measured within 3 months preoperatively and ≥ 6 months of follow-up. Obesity was defined as BMI ≥ 30 kg/m²; elevated HbA1c as ≥ 7%. Overall survival (OS) and cancer-specific survival (CSS) were assessed using Cox proportional hazards models and Kaplan-Meier analysis.</div></div><div><h3>Results</h3><div>770 patients met inclusion criteria. Median follow-up was 45.2 months; 172 (22%) mortality events occurred. Among patients with HbA1c &lt; 7%, patients with obesity demonstrated improved CSS (HR 0.21 [95% CI, 0.09-0.48], <em>P</em> &lt; .001) compared to non-obese counterparts after controlling for confounders. In patients with HbA1c ≥ 7%, no significant survival advantage in CSS was seen with obesity (HR 0.69 [95% CI, 0.16-3.03], <em>P</em> = .627). In patients with obesity, HbA1c ≥ 7% independently predicted worse OS (HR 2.36 [95% CI, 1.40-3.98], <em>P</em> &lt; .001).</div></div><div><h3>Conclusion</h3><div>The survival benefit from the obesity paradox in RCC patients appears limited to patients with well-controlled HbA1c. Elevated HbA1c may negate this effect, suggesting optimization of metabolic health and glycemic control may improve outcomes.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102457"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145463149","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":"A Systematic Review and Meta-Analysis of the Effectiveness and Safety of Immune Checkpoint Inhibitors in Patients With BCG-Unresponsive Non-Muscle-Invasive Bladder Cancer","authors":"Asmaa Soliman ,&nbsp;Mohamed R. Murad ,&nbsp;George Jabrieh ,&nbsp;Esraa M. AlEdani ,&nbsp;Abdelrahman Saeed ,&nbsp;Zineddine Belabaci ,&nbsp;Thoria I. Essa Ghanm ,&nbsp;Israa Ahmed Qutob","doi":"10.1016/j.clgc.2025.102445","DOIUrl":"10.1016/j.clgc.2025.102445","url":null,"abstract":"<div><div>The primary cancer of the urinary system is bladder cancer, which includes 2 subtypes: muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC). Intravesical Bacillus Calmette-Guérin (BCG) therapy remains the gold standard for treating individuals with high-risk NMIBC. However, disease development and recurrence pose serious clinical problems. This study aims to evaluate the safety and efficacy of immune checkpoint inhibitors (ICIs) as innovative therapeutic approaches for patients with BCG-unresponsive NMIBC. We conducted this study according to the PRISMA guidelines. We systematically reviewed clinical trials that evaluated ICIs as a treatment for BCG-unresponsive NMIBC and reported predefined efficacy and safety outcomes. We synthesized data using R software and evaluated the risk of bias using the ROBINS-I tool. Nine studies (488 patients) were included in the review, of which 6 were pooled in the meta-analysis. Following ICI therapy, the complete response (CR) rates were 36% at 3 months, 25% at 6 months, and 18% at twelve months. Across all studies, 14% of patients had a radical cystectomy (RC), with the lowest rates occurring in patients receiving atezolizumab. Treatment-related adverse events (TrAEs) were common, occurring in 15% of patients at grades 3 to 5 and 67% of patients at grades 1 to 2. Adverse events related to the immune system (IrAEs) were noted in 6% of individuals with grades (3-5) and 22% of patients with (grades 1-2). Serious adverse events occurred in 15% of patients overall; the atezolizumab group had a greater incidence (21%) than the pembrolizumab group (11%). Immune checkpoint inhibitors have shown encouraging effectiveness and safety in treating BCG-unresponsive NMIBC. However, the observed variability in therapeutic response and adverse events highlights the necessity for large-scale RCTs to clarify long-term efficacy and inform patient selection for ICI-based therapies.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102445"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373468","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":"Analysis of Clinicopathologic Features and Imaging Findings of TFE3-Rearranged Renal Cell Carcinoma","authors":"Jianqiang Liu ,&nbsp;Jinyan Wei ,&nbsp;Yuting Zhang ,&nbsp;Sitong Han ,&nbsp;Qi Zhang ,&nbsp;Enbo Hu ,&nbsp;Xuejian Sun ,&nbsp;Gang Wang ,&nbsp;Jianhong Zhao","doi":"10.1016/j.clgc.2025.102446","DOIUrl":"10.1016/j.clgc.2025.102446","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the imaging features and clinicopathologic features of TFE3-rearranged renal cell carcinoma and highlight key imaging findings for clinical decision-making.</div></div><div><h3>Methods</h3><div>The imaging and clinicopathological data of 49 pathologically confirmed cases of TFE3-rearranged renal cell carcinoma from multiple institutions between January 2018 and December 2024 were retrospectively analyzed.</div></div><div><h3>Results</h3><div>Of the 49 patients, 17 were male and 32 were female; aged 44 ± 15 years (range: 10-82 years) , 22 were asymptomatic and 27 were symptomatic. Tumor size averaged 7.0 (range: 2.0-14.9) cm. Imaging showed 28 round-like and 21 lobulated lesions; 18 had distinct margins, while 31 had indistinct margins. A pseudocapsule was present in 36 cases, 24 of which were incomplete. Additionally, 42 tumors showed uneven density with necrosis or cystic degeneration; there were 25 cases of hemorrhage, 27 cases of irregular calcification, Peritumoral vessels were noted in 23 cases. Imaging modalities included CT (44 cases: 41 with both plain and enhanced scans, 3 with plain only), MRI (13 cases with plain and enhanced scans), and ultrasonography (15 cases, including 5 with contrast enhancement). Treatment included partial nephrectomy (21 cases), total nephrectomy (22 cases) , and biopsy (6 cases).With a median follow-up of 30 months (range: 1-72 months) until December 2024, 6 patients experienced tumor recurrence, 14 developed metastasis, and 7 died, while 5 patients were lost to follow-up.</div></div><div><h3>Conclusion</h3><div>TFE3-rearranged renal cell carcinoma is a rare renal tumor with distinct imaging and clinical features that can inform preoperative diagnosis, treatment, and prognosis.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102446"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454229","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":"Long-Term Mortality Trends From Prostate Cancer and Associated Second Malignancies in the U.S., 1999 to 2023: Implications for Survivorship Care","authors":"Shree Rath ,&nbsp;Amar Lal ,&nbsp;Ahmed Hasan ,&nbsp;Muhammad Ali ,&nbsp;Laiba Sultan ,&nbsp;Mishaim Khan ,&nbsp;Umama Alam","doi":"10.1016/j.clgc.2025.102428","DOIUrl":"10.1016/j.clgc.2025.102428","url":null,"abstract":"<div><h3>Introduction</h3><div>Prostate cancer remains the most commonly diagnosed malignancy among men in the United States. However, the risk and burden of secondary malignancies (SMs) among this group are not well characterized. This study examines national trends in mortality attributable to SMs among prostate cancer survivors, with an emphasis on demographic and geographic disparities.</div></div><div><h3>Methods</h3><div>Utilizing data from the CDC WONDER, we conducted a population-based analysis of mortality rates linked to SPMs in individuals aged 65 and older with a prior prostate cancer diagnosis, spanning 1999 to 2023. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 population and stratified by age, race/ethnicity, region, and urbanization. Joinpoint regression was used to assess changes in trends and annual percent change (APC).</div></div><div><h3>Results</h3><div>From 1999 to 2023, a total of 115,041 deaths were attributed to SMs in prostate cancer, with an overall Age-adjusted mortality rate (AAMR) of 26.21 (95% CI, 25.43-26.99). Trends showed a significant decline from 1999 to 2006, followed by a significant rise in the periods of 2013 to 2017 (APC = 8.17%) and 2017 to 2023 (APC = 4.71; 95% CI, 3.03-5.5.75). Racial disparities were evident, with non-Hispanic White individuals exhibiting an overall incline in contrast to non-Hispanic Black individuals, who experienced a decrease. Notably, men aged 85 years and older had a statistically significant long-term rise in mortality (AAPC = 0.92), in contrast with younger groups, which demonstrated early declines and nonsignificant long-term trends.</div></div><div><h3>Conclusions</h3><div>Mortality from SMs among U.S. prostate cancer survivors has increased in complexity over the past 24 years, with pronounced disparities by race, region, urbanization, and age group. These findings highlight the need for enhanced survivorship care, targeted screening, and public health interventions to address growing risks and ensure equitable outcomes for all affected populations.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102428"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152207","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":"Oral Toxicities of PSMA-Targeted Therapies: Mitigation Strategies and Translational Opportunities","authors":"Chitra Priya Emperumal ,&nbsp;Nagarajan Kannan ,&nbsp;Daniel S. Childs ,&nbsp;Bridget P. Keenan","doi":"10.1016/j.clgc.2025.102452","DOIUrl":"10.1016/j.clgc.2025.102452","url":null,"abstract":"<div><div>Prostate-specific membrane antigen (PSMA) has gained prominence as a key target in the treatment of metastatic castration-resistant prostate cancer (mCRPC) therapy. Integrating radionuclide therapies such as Lutetium-177 [¹⁷⁷Lu]-PSMA-617 has significantly advanced treatment outcomes while posing unique challenges related to off-tumor toxicities in other tissues that express PSMA, particularly in salivary glands. Furthermore, there are novel cancer therapeutics in development including PSMA-targeted immunotherapies and antibody drug conjugates which hold promise for the treatment of prostate cancer and may contribute to the burden of oral toxicity. The oral toxicity of PSMA-targeted radioligand therapy arises from PSMA-mediated salivary gland uptake and radionuclide retention, differing fundamentally from the nonspecific tissue damage mechanisms of traditional external beam radiotherapy. In parallel, targeted therapies, including small molecules and monoclonal antibodies, exert direct effects by binding to PSMA and delivering anti-tumor metabolites and/or amplifying the immune response. The resultant off-tumor on-target tissue damage can lead to distinct oral complications such as xerostomia, dysgeusia and mucositis. Although PSMA–targeted therapies are primarily used for the management of prostate cancer, they are also being explored in treatment of salivary gland malignancies including adenoid cystic carcinoma. This review explores the mechanisms and clinical manifestations of PSMA-related oral toxicities in the context of prostate cancer, diagnosis, possible mitigation strategies, the need for preclinical models to study regulation of PSMA expression leading to oral toxicities, current challenges and future directions.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102452"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145412397","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":"Optimizing Unilateral Pelvic Lymph Node Dissection in the PSMA Era: Balancing Oncological Safety, Contralateral Involvement Risk, and Overtreatment in Prostate Cancer: A Multicenter Study of the Turkish Urooncology Association","authors":"Cagri Akpinar ,&nbsp;Evren Suer ,&nbsp;Nejdet Karsıyakalı ,&nbsp;Nihat Karakoyunlu ,&nbsp;Serhat Cetin ,&nbsp;Güven Aslan ,&nbsp;Deniz Bolat ,&nbsp;Volkan Izol ,&nbsp;Cenk Y. Bilen ,&nbsp;Sinan Sozen ,&nbsp;Levent Turkeri ,&nbsp;Sumer Baltaci","doi":"10.1016/j.clgc.2025.102432","DOIUrl":"10.1016/j.clgc.2025.102432","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the risk of contralateral lymph node involvement (LNI) and the feasibility of safely performing unilateral pelvic lymph node dissection (PLND) in unfavorable-intermediate and high-risk prostate cancer (PCa) patients with cN0 status on preoperative ⁶⁸Ga-PSMA PET/CT, tumor involvement in single lobe, or dominant lobe involvement with worse tumor characteristics on biopsy.</div></div><div><h3>Material and Methods</h3><div>In this retrospective multicenter study were analyzed 768 patients who underwent RP and bilateral extended-PLND. Patients with cN0 status on PSMA PET/CT and PI-RADS ≥ 3 lesions on multiparametric magnetic resonance imaging(mpMRI) were included. Tumor lobe (single/dominant-prostatic lobe) involvement and LNI status were recorded for all patients. The dominant lobe was determined based on higher ISUP grade group(GG), number and percentage of more positive cores, and more advanced features on MRI, respectively. LNI status was analyzed by tumor side and location. Statistical analysis included univariate and multivariate models to evaluate predictors of contralateral LNI.</div></div><div><h3>Results</h3><div>LNI was observed in 96(12.5%) of 768 patients, with 61(7.9%) having ipsilateral LNI and 35(4.6%) contralateral LNI with or without ipsilateral LNI. Patients with contralateral LNI had higher preoperative PSA, more frequent EAU high-risk classification, larger-index lesion diameter, higher ISUP GG on both the dominant and nondominant side, and a higher rate of positive percentages in the nondominant side (all <em>P</em> values &lt; .05). Multivariate analysis identified preoperative PSA (HR 1.028, 95% Cl 1.001-1.057, <em>P</em> = .044), ISUP GG 2 (HR 4.325,95% Cl-1.620-14.374,<em>P</em> = .007<em>)</em> and ≥ ISUP-GG 3 (HR 14.004, 95% Cl 3.025-54.773, <em>P</em> &lt; .001) on the nondominant side as independent predictors for contralateral LNI. The ROC-derived AUC for predicting contralateral LNI was 0.873, indicating good predictive accuracy.</div></div><div><h3>Conclusion</h3><div>In cases where preoperative ⁶⁸Ga-PSMA PET/CT indicates a negative LN status, contralateral PLND may not be necessary in intermediate-risk patients with negative biopsy or ISUP GG 1 tumor on the nondominant side.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102432"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276903","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 and Clinical Implications of Tumor Microenvironment Evaluated With Multiplex Immunohistochemistry in Testicular Embryonal Carcinoma","authors":"Valentina Tateo ,&nbsp;Costantino Ricci ,&nbsp;Sofia Melotti ,&nbsp;Elisa Tassinari ,&nbsp;Matteo Rosellini ,&nbsp;Andrea Marchetti ,&nbsp;Linda Danielli ,&nbsp;Antonio Maestri ,&nbsp;Andrea Necchi ,&nbsp;Veronica Mollica ,&nbsp;Michelangelo Fiorentino ,&nbsp;Francesco Massari","doi":"10.1016/j.clgc.2025.102444","DOIUrl":"10.1016/j.clgc.2025.102444","url":null,"abstract":"<div><h3>Introduction</h3><div>Testicular germ cell tumors (TGCTs) are the most common cancer in young men. Their development is closely linked to embryogenesis, yet much about their pathogenesis remains unknown. TGCTs exhibit exceptional sensitivity to cisplatin-based chemotherapy, achieving high cure rates even in metastatic disease. Further research is needed to deepen our understanding of TGCTs and refine risk stratification. In this pilot study, we focused on embryonal carcinoma (EC), a subtype with increased risk of relapse and considered a key step in TGCT reprogramming.</div></div><div><h3>Patients and Methods</h3><div>We analyzed the tumor microenvironment (TME) in 49 EC samples using bright-field multiplex immunohistochemistry (BF-mIHC), which enables the simultaneous evaluation of multiple biomarkers, making it particularly useful for TME characterization. We evaluated B-cells (CD20), T-cells (CD3), and tumor-associated macrophages (TAMs, CD68) and established cutoffs that correlated with reprogramming phase, clinical stage, and relapse.</div></div><div><h3>Results</h3><div>High TAM levels (CD68 + &gt; 83/mm²) were strongly associated with phase I of reprogramming (pure EC or EC mixed only with seminoma), while low TAM characterized phase II (<em>P</em> <em>&lt;</em> <em>.</em>001), suggesting a role in stemness maintenance through epigenetic regulation. High CD68 (&gt; 46/mm²) and CD3 (&gt; 125.5/mm²) correlated with metastatic disease (<em>P</em> <em>&lt;</em> <em>.</em>001 and <em>P</em> <em>=</em> <em>.</em>026, respectively), whereas high CD20 (&gt; 38.5/mm²) and CD3 (&gt; 83/mm²) were linked to lower relapse risk (<em>P</em> <em>=</em> <em>.</em>014 and <em>P</em> <em>=</em> <em>.</em>017, respectively). Important limits are small sample size and few relapse events.</div></div><div><h3>Conclusions</h3><div>These findings highlight the relevance of TME in TGCT biology and prognosis. The observed associations suggest TME may influence tumor plasticity, metastatization and relapse risk, warranting validation in larger studies.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 6","pages":"Article 102444"},"PeriodicalIF":2.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373387","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}