Clinical genitourinary cancer最新文献

{"title":"Racial Differences in Survival and Healthcare Resource Utilization Among Medicaid-Insured Adults With Metastatic Prostate Cancer","authors":"Maral DerSarkissian ,&nbsp;Bhakti Arondekar ,&nbsp;Deepshekhar Gupta ,&nbsp;Jasmina Ivanova ,&nbsp;Alexander Niyazov ,&nbsp;Enrico Zanardo ,&nbsp;Tracy Guo ,&nbsp;Jingru Wang ,&nbsp;Mei Sheng Duh ,&nbsp;Stephen J. Freedland","doi":"10.1016/j.clgc.2024.102291","DOIUrl":"10.1016/j.clgc.2024.102291","url":null,"abstract":"<div><h3>Introduction</h3><div>Racial disparities in prostate cancer (PC) are well studied among Black or African American (BAA) patients but not among Hispanics, a quickly growing US minority group. This study compared overall survival (OS) and healthcare resource utilization (HRU) by race in Medicaid-insured patients with metastatic castration-sensitive PC (mCSPC) and metastatic castration-resistant PC (mCRPC).</div></div><div><h3>Materials and methods</h3><div>A retrospective longitudinal cohort study of Medicaid claims was conducted to estimate racial disparities in OS (with a multivariable Cox proportional hazards model) and in HRU (with a multivariable Poisson model), adjusting for confounding by demographic and clinical characteristics. Analyses were conducted separately for mCSPC and mCRPC.</div></div><div><h3>Results</h3><div>The study included 1,253 mCSPC patients (BAA: N = 467; White: N = 446; Hispanic: N = 219; Other races: N = 121) and 871 mCRPC patients (BAA: N = 278; White: N = 320; Hispanic: N = 190; Other races: N = 83). Among mCSPC patients, Hispanic patients had significantly longer adjusted survival vs. White patients (hazard ratio (HR); 95% confidence interval: 0.63; 0.42-0.94). BAA and White patients had comparable survival (0.87; 0.66-1.15). BAA patients had lower rates of adjusted PC-related outpatient (OP) visits vs. White patients (incidence rate ratios [IRR] 0.72; 0.55-0.96). Among mCRPC patients, Hispanic patients had longer survival vs. White patients (HR: 0.63; 0.43-0.93). BAA and White patients had comparable survival (HR: 0.84; 0.62-1.14). BAA patients had significantly fewer PC-related OP visits vs. White patients (IRR: 0.71; 0.55-0.92) and significantly more PC-related emergency room (ER) visits (IRR: 5.41; 1.94-15.09) and inpatient admissions (IRR: 1.90; 1.10-3.25).</div></div><div><h3>Conclusion</h3><div>White and BAA Medicaid-insured patients with mCSPC and mCRPC had similar survival outcomes, whereas Hispanic patients, an under-studied minority group, had significantly longer survival compared to White patients. Differential HRU was observed among racial groups to different extents in the mCSPC and mCRPC cohorts. Further studies are needed to understand the relation between racial disparities in HRU and OS.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102291"},"PeriodicalIF":2.3,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018248","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":"Feasibility and Oncological Outcome of Patients Achieving Noninvasive Downstaging After Transurethral Resection of Bladder Tumor Plus Systemic Chemotherapy for Bladder Preservation Strategy in Muscle-Invasive Bladder Cancer","authors":"Takehisa Onishi ,&nbsp;Takuji Shibahara ,&nbsp;Sho Sekito ,&nbsp;Manabu Kato ,&nbsp;Yusuke Sugino ,&nbsp;Takahiro Inoue","doi":"10.1016/j.clgc.2024.102290","DOIUrl":"10.1016/j.clgc.2024.102290","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the oncological outcomes of selective bladder preservation therapy, comprising maximal TURBT plus neoadjuvant chemotherapy (NAC) followed by 2nd-TURBT.</div></div><div><h3>Methods</h3><div>From 2012 to 2022, 110 localized muscle-invasive bladder cancer patients who desired bladder preservation (BP) received maximal TURBT plus NAC followed by restaging (CT scan+ 1st-TURBT) and 2nd-TURBT. Sixty-one patients with pure urothelial carcinoma of the urinary bladder (PUCUB) who achieved noninvasive downstaging (NID) after NAC and had no residual tumor at 2nd-TURBT underwent conservative treatment (BP group). Overall survival (OS), cancer-specific survival (CSS), distant metastasis-free survival (DMFS), and cystectomy and distant metastasis-free survival (CDMFS) were estimated using the Kaplan-Meyer method. Propensity score matching was performed to compare the survival outcomes of patients in the BP group with those who underwent NAC + radical cystectomy (RC) and were diagnosed with ypT1 or less (RC group, n = 42). Multivariable Cox regression (MCR) models addressed survivals according to each treatment method.</div></div><div><h3>Results</h3><div>In the BP group, 5-year OS, CSS, DMFS, and CDMFS were 87.4%, 93.8%, 83.1%, and 76.8%, respectively. MCR models for survival showed no differences in OS (BP: hazard ratio [HR] 1.24, <em>P</em> = .83), CSS (BP: HR 1.15, <em>P</em> = .74), and DMFS (BP: HR 1.09, <em>P</em> = .91) between the matched cohort.</div></div><div><h3>Conclusions</h3><div>BP therapy incorporating maximal TURBT plus NAC followed by 2nd-TURBT may be used as an alternative therapy to RC for selected muscle-invasive PUCUB patients. As this was a retrospective study, further randomized trials with longer follow-up are needed.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102290"},"PeriodicalIF":2.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973839","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":"Comprehensive Genetic Profile of Chinese Muscle-Invasive Bladder Cancer Cohort","authors":"Sujun Han ,&nbsp;Yining Li ,&nbsp;Dong Chen ,&nbsp;Zhannan Si ,&nbsp;Tao Xu ,&nbsp;Yiqing Du ,&nbsp;Nianzeng Xing","doi":"10.1016/j.clgc.2024.102280","DOIUrl":"10.1016/j.clgc.2024.102280","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of our study was to characterize the spectrum of mutations in muscle-invasive bladder cancer (MIBC) in the Chinese population, identifying mutational features and exploring potential therapeutic targets.</div></div><div><h3>Methods</h3><div>We collected samples from 62 Chinese patients with MIBC. For each patient, tumor tissues or blood samples were collected and sequenced by whole exome sequencing.</div></div><div><h3>Results</h3><div>Our findings revealed the most frequently mutated genes included <em>TP53</em> (41%), <em>TTN</em> (41%), <em>HYDIN</em> (34%), <em>FRG1</em> (33%), <em>ZNF717</em> (23%), <em>AHNAK2</em> (21%), <em>MUC4</em> (21%), <em>KMT2D</em> (20%), <em>CDC27</em> (18%) and <em>IGSF3</em> (18%). The most frequently mutated DNA damage repair (DDR) genes were <em>TP53</em> (49%), <em>SMARCA4</em> (10%), <em>ERCC2</em> (8%), <em>BRAC2</em> (6%), <em>HERC2</em> (6%), <em>HLTF</em> (6%), <em>PALB2</em> (6%) and <em>POLG</em> (6%). Additionally, our analysis confirmed an association between DDR mutations and high TMB (<em>P</em> = .022). Significant differences in MSI were observed between smokers and nonsmokers (<em>P</em> = .022), drinkers and nondrinkers (<em>P</em> = .018). By analyzing the data of 323 white MIBC samples from TCGA database, we identified frequently mutated driver genes in both our cohort and TCGA white cohort, including <em>TP53, KMT2D, KMT2C</em>, and <em>FGFR3</em>. Our study also revealed genes with distinct mutation frequencies compared to the TCGA white cohort, including <em>FRG1, CDC27, IGSF3, MUC16</em>, and <em>ARID1A</em>.</div></div><div><h3>Conclusions</h3><div>Our study provided comprehensive insights into genomic alterations in a cohort of Chinese MIBC, which could provide potential clues for clinical applications.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102280"},"PeriodicalIF":2.3,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018328","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":"","authors":"","doi":"10.1016/j.clgc.2024.102247","DOIUrl":"10.1016/j.clgc.2024.102247","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102247"},"PeriodicalIF":2.3,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678038","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 Histology on Clinical Outcomes of Pembrolizumab Monotherapy in Patients With Advanced or Metastatic Urothelial Carcinoma in the Phase 3 KEYNOTE-045 and KEYNOTE-361 Trials","authors":"Patrizia Giannatempo ,&nbsp;Jean-Pascal Machiels ,&nbsp;Naoto Sassa ,&nbsp;Jose Angel Arranz ,&nbsp;Yasuhisa Fujii ,&nbsp;Wen-Pin Su ,&nbsp;Bhumsuk Keam ,&nbsp;Stéphane Culine ,&nbsp;Ying-Chun Shen ,&nbsp;José Muñoz Langa ,&nbsp;David Sarid ,&nbsp;Maureen Aarts ,&nbsp;Fabio Calabrò ,&nbsp;Eli Rosenbaum ,&nbsp;Blanca Homet Moreno ,&nbsp;Abhishek Bavle ,&nbsp;Jin Z. Xu ,&nbsp;Sun Young Rha","doi":"10.1016/j.clgc.2024.102273","DOIUrl":"10.1016/j.clgc.2024.102273","url":null,"abstract":"<div><h3>Introduction</h3><div>A post hoc analysis of efficacy and safety outcomes with pembrolizumab monotherapy was conducted in patients with advanced or metastatic urothelial carcinoma (UC) with pure transitional cell carcinoma (TCC) or mixed predominant TCC histology enrolled in the phase 3 KEYNOTE-045 and KEYNOTE-361 studies.</div></div><div><h3>Methods</h3><div>Adults with platinum-refractory advanced or metastatic UC who received pembrolizumab monotherapy in KEYNOTE-045 and adults with advanced or metastatic UC and no prior systemic chemotherapy who received pembrolizumab monotherapy in KEYNOTE-361 were analyzed separately. Pembrolizumab 200 mg was administered intravenously every 3 weeks for ≤2 years. Histology was assessed by investigator. End points included objective response rate (ORR), progression-free survival, and duration of response per RECIST v1.1 by central radiology assessment, as well as overall survival (OS) and safety.</div></div><div><h3>Results</h3><div>In KEYNOTE-045, 268 patients had known histology (pure TCC: 186; mixed predominant TCC: 82). At data cutoff (October 1, 2020), median follow up was 62.9 months (range, 59.0-70.9). For pure TCC, confirmed ORR was 21.0% (95% CI, 15.4-27.5); median OS was 9.7 months (95% CI, 7.5-11.8). For mixed predominant TCC, confirmed ORR was 24.4% (95% CI, 15.6-35.1); median OS was 11.6 months (95% CI, 7.4-16.4). In KEYNOTE-361, 307 patients had known histology (pure TCC: 280; mixed predominant TCC: 27). At data cutoff (April 29, 2020), median follow-up was 32.5 months (range, 22.0-42.3). For pure TCC, confirmed ORR was 29.3% (95% CI, 24.0-35.0); median OS was 14.8 months (95% CI, 11.8-17.9). For mixed predominant TCC, confirmed ORR was 40.7% (95% CI, 22.4-61.2); median OS was 16.2 months (95% CI, 5.5-NR). Grade 3-5 treatment-related adverse events occurred at similar rates for treated patients in both studies.</div></div><div><h3>Conclusion</h3><div>In this post hoc analysis, efficacy and safety outcomes with pembrolizumab monotherapy were generally consistent for patients with advanced or metastatic UC in KEYNOTE-045 and KEYNOTE-361 studies between histology subgroups.</div></div><div><h3>Clinical Trial Registration</h3><div>ClinicalTrials.gov, KEYNOTE-045 (NCT02256436) and KEYNOTE-361 (NCT02853305)</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 2","pages":"Article 102273"},"PeriodicalIF":2.3,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534340","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":"ALK-Rearranged Renal Cell Carcinoma: A Study of Three Cases With Clinicopathologic Features and Effect of Postoperative Adjuvant Immunotherapy","authors":"Xinting Zhang ,&nbsp;Chaoran Ban ,&nbsp;Yupeng Chen ,&nbsp;Sheng Zhang ,&nbsp;Hong Chen","doi":"10.1016/j.clgc.2024.102266","DOIUrl":"10.1016/j.clgc.2024.102266","url":null,"abstract":"<div><h3>Background</h3><div>ALK-rearranged renal cell carcinoma (ALK-RCC) is a rare malignant epithelial tumor of the kidney. ALK-RCC has recently been listed in the 5^th edition of the World Health Organization (WHO) Classification of Tumors as a molecularly defined RCC subtype.</div></div><div><h3>Patients and Methods</h3><div>We describe retrospectively 3 ALK-RCCs from clinicopathologic, immunohistochemical (IHC), and molecular genetic aspects, along with postoperative adjuvant therapeutic regime and prognosis-related information.</div></div><div><h3>Results</h3><div>Two patients were female and one patient was male. Patients’ age ranged from 38 to 64 years (mean 51.3 years). Tumor size ranged from 32 mm to 89 mm (mean 55.3 mm, median 45 mm). All 3 tumors were diffusely positive for ALK protein. ALK fusion partners (TPM3 for case 1, VCL for case 2, and EML4 for case 3) were identified by next-generation sequencing. Histomorphologically, the tumors were heterogeneous, showing tubulocystic, papillary, trabecular, and solid growth patterns and polygonal to rhabdoid neoplastic cells. Cases 1 and 3 set in a mucinous background. Upon quantification of tumor-associated CD8⁺ T cells by IHC, tumor immune phenotypes (IPs) were defined as immune-desert in case 1, immune-inflamed in case 2, and immune-excluded in case 3. Follow-up for the 3 patients ranged from 18 to 129 months (mean, 59.3 months). Case 1 refused postoperative adjuvant therapy and was alive without disease at 129-month follow-up. Case 2 was postoperatively treated with a PD-1-targeted monoclonal antibody, being alive without disease at 18-month follow-up. Case 3 showed retroperitoneal lymph nodes and lung metastases at initial diagnosis. She was postoperatively treated with a PD-1-targeted monoclonal antibody, with no benefit suggested by computed tomography on follow-up.</div></div><div><h3>Conclusion</h3><div>ALK-RCC represents a distinct entity with clinicopathological, genetic, and immunophenotypic heterogeneity. ALK IHC analysis during primary screening may aid diagnosis in difficult cases. For progressive ALK-RCCs, postoperative adjuvant immunotherapy may be best selected according to IP features. Patients with immune-excluded phenotypes may not benefit from immunotherapy.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102266"},"PeriodicalIF":2.3,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759429","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":"Prospective Study of Patient, Nursing, and Oncology Provider Perspectives on Telemedicine Visits for Renal Cell Carcinoma Clinical Trials","authors":"Sahil D. Doshi ,&nbsp;Andrea Knezevic ,&nbsp;Carlene Gonzalez ,&nbsp;Patricia Fischer ,&nbsp;Robert Goodman ,&nbsp;Suzanne Gornell ,&nbsp;Sweta Patel ,&nbsp;Cindy Puzio ,&nbsp;Alisa Ritea ,&nbsp;Chung-Han Lee ,&nbsp;Lauren Evans ,&nbsp;Martin H. Voss ,&nbsp;Robert J. Motzer ,&nbsp;Ritesh R. Kotecha","doi":"10.1016/j.clgc.2024.102268","DOIUrl":"10.1016/j.clgc.2024.102268","url":null,"abstract":"<div><h3>Purpose</h3><div>Clinical trials enable renal cell carcinoma (RCC) patients to receive promising investigational agents, yet access may be limited. Telemedicine (TM) is an increasingly utilized platform that can expand access, but perspectives on its use in clinical trial care are unknown.</div></div><div><h3>Patients and Methods</h3><div>A prospective study was conducted between Jan 2023 – Oct 2023 at Memorial Sloan Kettering Cancer Center. RCC patients enrolled on therapeutic clinical trials who had prior TM visits were eligible. Surveys in English were distributed to patients, treating clinical trial nurses (CTNs), and oncology providers engaged in clinical trials.</div></div><div><h3>Results</h3><div>39 patients, 7 CTNs, and 15 oncology providers were included in our analysis. Regarding clinical trial care, 26 patients (67%) preferred in-person, 4 (11%) preferred TM, and 9 (22%) had no preference. However, 25 patients (64%) reported TM provided an equal quality of care, and 38 (97%) reported a positive or neutral experience. Conversely, 7 CTNs (100%) and 11 providers (73%) preferred in-person care while 4 (27%) indicated no preference. Most, including 6 CTNs (86%) and 13 providers (87%), reported that TM quality of care was inferior. However, most, including 7 CTNs (100%) and 14 providers (93%), reported a positive experience with TM.</div></div><div><h3>Conclusions</h3><div>In this study, one third of RCC participants preferred TM or had no preference, and a majority felt TM delivered equal quality of care. Providers, however, preferred in-person visits and reported inferior quality of care with TM. These findings warrant further evaluation of safety and feasibility to optimize TM integration for clinical trial care delivery.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102268"},"PeriodicalIF":2.3,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745146","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":"Prognostic Impact of IMDC Category Shift From Baseline to Nivolumab Initiation in Metastatic Renal Cell Carcinoma: A Sub-Analysis of the MEET-URO 15 Study","authors":"Brigida Anna Maiorano ,&nbsp;Martina Catalano ,&nbsp;Chiara Mercinelli ,&nbsp;Giandomenico Roviello ,&nbsp;Marco Maruzzo ,&nbsp;Ugo De Giorgi ,&nbsp;Silvia Chiellino ,&nbsp;Andrea Sbrana ,&nbsp;Luca Galli ,&nbsp;Paolo Andrea Zucali ,&nbsp;Cristina Masini ,&nbsp;Emanuele Naglieri ,&nbsp;Giuseppe Procopio ,&nbsp;Sara Merler ,&nbsp;Lucia Fratino ,&nbsp;Cinzia Baldessari ,&nbsp;Riccardo Ricotta ,&nbsp;Veronica Mollica ,&nbsp;Mariella Sorarù ,&nbsp;Marianna Tudini ,&nbsp;Sara Elena Rebuzzi","doi":"10.1016/j.clgc.2024.102267","DOIUrl":"10.1016/j.clgc.2024.102267","url":null,"abstract":"<div><h3>Introduction</h3><div>The International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score is the most important prognostic score to stratify patients with metastatic renal cell carcinoma (mRCC), helping to guide treatment choice in first line. We hypothesized that IMDC change may also exert a prognostic role in subsequent lines of mRCC therapy.</div></div><div><h3>Methods</h3><div>Meet-URO 15 is a multicenter Italian study of patients with mRCC receiving nivolumab as a second or subsequent line of therapy. This posthoc analysis aimed to evaluate the overall survival (OS) and progression-free survival (PFS) from nivolumab start as primary endpoints, overall response rate (ORR) and disease-control rate (DCR) as secondary endpoints, according to the change in the IMDC category from the first-line setting (baseline) to nivolumab start. Patients with available prognostic IMDC category information at baseline and before nivolumab were included.</div></div><div><h3>Results</h3><div>492 patients were included in the analysis. At baseline, 165 (33.5%), 287 (58.3%), and 40 patients (8.2%) had favorable, intermediate, and poor IMDC categories, respectively. Before nivolumab, 364 patients (73.9%) remained in the same prognostic category as at baseline, 27 (5.5%) improved, and 101 (20.5%) deteriorated. Significantly longer mPFS (<em>P</em> = .01) and mOS (<em>P</em> &lt; .01) were reached by patients with a stable favorable group compared to those worsening to intermediate/poor. A longer mOS was also achieved from intermediate/poor patients who improved their IMDC category before nivolumab compared to those remaining stable/worsening (<em>P</em> &lt; .01 and <em>P</em> = .04, respectively). Maintaining IMDC category stability from baseline to nivolumab determined a more consistent DCR in favorable patients (<em>P</em> = .03). Overall, patients who improved their IMDC risk score reached better survival outcomes than those who remained stable/deteriorated.</div></div><div><h3>Conclusions</h3><div>In our sub-analysis, the shift in the IMDC risk category appears to be a helpful prognostic tool for assessing the outcomes of patients with mRCC treated with ≥2nd line nivolumab.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102267"},"PeriodicalIF":2.3,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142721078","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":"Letter to the Editor: Risk of Metachronous Upper Tract Urothelial Carcinoma After Ureteral Stenting in Patients With Bladder Cancer","authors":"Kamil Malshy,&nbsp;Matthew Steidle,&nbsp;William Tabayoyong,&nbsp;Edward M. Messing","doi":"10.1016/j.clgc.2024.102263","DOIUrl":"10.1016/j.clgc.2024.102263","url":null,"abstract":"","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102263"},"PeriodicalIF":2.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142745145","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":"Differential Analysis of Surgical Treatment Modalities in T2N0M0 Bladder Cancer Patients: A Novel Propensity Score-Based Cohort Study","authors":"Yu-Xuan Yang,&nbsp;Gui-Chen Ye,&nbsp;Jia-Cheng Xiang,&nbsp;Kuang-Di Luo,&nbsp;Shao-Gang Wang ,&nbsp;Qi-Dong Xia","doi":"10.1016/j.clgc.2024.102257","DOIUrl":"10.1016/j.clgc.2024.102257","url":null,"abstract":"<div><h3>Objective</h3><div>This study explored prognostic differences between radical cystectomy (RC), tri-modality treatment (TURBt combined with radiotherapy and chemotherapy, TMT), electrocautery (EC) and partial cystectomy (PC) for T2N0M0 MIBC.</div></div><div><h3>Materials and Methods</h3><div>Using SEER data (2004-2015, 2018-2020), we identified T2N0M0 MIBC patients treated with RC, TMT, EC, or PC. Propensity score matching (PSM, 1:1, caliper=0.1) minimized confounding. Kaplan-Meier analysis and Cox regression identified independent prognostic factors, stratified by tumor size and age.</div></div><div><h3>Result</h3><div>This study included 6526 patients with T2N0M0 MIBC. Among them, 348(5.33%) underwent PC, 309(4.73%)underwent EC, 1833(28.09%)received TMT, and 4036(61.84%) RC. After 1:1 propensity score matching, RC showed improved CSS (HR=0.67, 95%CI 0.47-0.95 , and PC also benefited (HR=0.97, 95%CI 0.69-1.36) compared to EC. While TMT showed a worse end (HR=1.41, 95%Cl 1.03-1.92) compared to EC. Cox analysis was used to stratify tumor size and age for subgroup analysis. Results for tumor size subgroups were aligned with PSM findings. In the age-stratified subgroups, patients aged &lt;67 years, both RC (HR=0.54, P=0.107) and TMT(HR=0.91, P=0.785) showed better prognoses compared to EC treatment, while PC treatment showed worse prognoses compared to EC treatment (HR=1.23, P=0.542).; for 68-77 years, RC(0.64, P=0.1436) and PC(HR=0.46, P=0.0283)had advantages, and PC is more recommended. For &gt;78 years, RC had superior CSS over EC and PC, whereas TMT had the poorest prognosis.</div></div><div><h3>Conclusion</h3><div>In clinical T2N0M0 MIBC, overall, RC outperformed focal-tumor therapy and PC, irrespective of tumor size. However, considering age, we recommend PC treatment for patients aged 68-77 and EC for those aged &gt;78 years.</div></div>","PeriodicalId":10380,"journal":{"name":"Clinical genitourinary cancer","volume":"23 1","pages":"Article 102257"},"PeriodicalIF":2.3,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694003","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}