European urology focus最新文献

{"title":"Belzutifan Efficacy and Tolerability in Patients with Sporadic Metastatic Clear Cell Renal Cell Carcinoma.","authors":"Emily Wang, Eric S Rupe, Sagar S Mukhida, Andrew C Johns, Matthew T Campbell, Amishi Y Shah, Amado J Zurita, Jianjun Gao, Sangeeta Goswami, Eric Jonasch, Pavlos Msaouel, Nizar M Tannir, Andrew W Hahn","doi":"10.1016/j.euf.2024.09.007","DOIUrl":"https://doi.org/10.1016/j.euf.2024.09.007","url":null,"abstract":"<p><strong>Background and objective: </strong>Belzutifan, a hypoxia-inducible factor 2 alpha inhibitor, was approved initially for patients with von Hippel-Lindau disease and more recently for sporadic, metastatic clear cell renal cell carcinoma (ccRCC) based on the results of LITESPARK-005. There is a paucity of data regarding real-world experience with belzutifan in patients with sporadic, metastatic ccRCC. This study aims to describe clinical outcomes with belzutifan in patients with sporadic, metastatic ccRCC.</p><p><strong>Methods: </strong>A retrospective study of 22 patients who received belzutifan at MD Anderson Cancer Center prior to the Food and Drug Administration approval was conducted. Progression-free survival (PFS) and objective response rate (ORR) were assessed by a blinded radiologist using Response Evaluation Criteria In Solid Tumors (RECIST) version 1.1. PFS and overall survival (OS) were measured from belzutifan initiation.</p><p><strong>Key findings and limitations: </strong>The median follow-up time was 14.9 mo. Most patients had International Metastatic RCC Database Consortium intermediate-risk disease, more than three metastatic sites, and a median of five prior lines of treatment at initiation of belzutifan; all patients received prior immune checkpoint therapy (ICT) and vascular endothelial growth factor receptor tyrosine kinase inhibitors (VEGFR-TKIs). The median PFS was 8.51 mo (95% confidence interval [CI] 0-18.4) and ORR was 36.4%. The median OS was 14.72 mo (95% CI 7.34-22.10). Of 22 patients, four (18.2%) patients required dose reductions and three (13.6%) patients discontinued belzutifan because of adverse drug events (ADEs). The most common ADEs were anemia (77.3%; 17/22) and hypoxia (36.4%; 8/22). There were no treatment-related deaths.</p><p><strong>Conclusions and clinical implications: </strong>In a heavily pretreated cohort of patients with sporadic, metastatic ccRCC, belzutifan had meaningful clinical activity and was well tolerated. These real-world results add to the results of LITESPARK-005 and support the use of belzutifan after progression on ICT and VEGFR-TKIs.</p><p><strong>Patient summary: </strong>Belzutifan is a new medicine used to treat a type of clear cell kidney cancer that has spread to other parts of the body (metastasized). A study at MD Anderson Cancer Center followed 22 patients who were treated with belzutifan, and found that it worked to control the cancer for almost 9 mo and caused the cancer to shrink in 36% of patients. This study confirms that belzutifan can be effective and safe, even after other treatments have not worked.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Impact of the CARMENA Trial on Cytoreductive Nephrectomy Practices in the USA: A Difference-in-differences Analysis.","authors":"Anna Geduldig, Jackson Schmidt, Jacob Grassauer, Wesley Chou, Nicholas H Chakiryan","doi":"10.1016/j.euf.2024.09.008","DOIUrl":"https://doi.org/10.1016/j.euf.2024.09.008","url":null,"abstract":"<p><strong>Background and objective: </strong>It is unclear whether cytoreductive nephrectomy (CN) practices have changed in the USA after the publication of the Cancer du Rein Métastatique Nephrectomie et Antiangiogéniques (CARMENA) trial in 2018. Our primary objective is to determine the effect of the CARMENA trial on CN rates in the USA.</p><p><strong>Methods: </strong>Patients were identified in the National Cancer Database from 2004 to 2020. A quasiexperimental difference-in-differences analysis was used to test the primary outcome, as follows: the change in CN rate was assessed among metastatic clear cell renal cell carcinoma (ccRCC) patients diagnosed before versus after 2018, while using the localized nephrectomy (LN) rate performed in the setting of nonmetastatic ccRCC as a control group.</p><p><strong>Key findings and limitations: </strong>The difference-in-differences analysis identified a statistically significant decrease in CN rate after CARMENA (β-coefficient [standard error]: -0.06 [0.025], p = 0.028), with a 10.2% absolute and a 31.8% relative rate reduction when compared with the counterfactual (expected) value (34.7% → 21.9% [actual] vs 32.1% [expected]). Primarily, relative differences in CN and LN rates before and after 2018 may be attributable to additional factors, aside from CARMENA publication, not tested in this quasiexperimental model.</p><p><strong>Conclusions and clinical implications: </strong>CN rates decreased significantly after the publication of the CARMENA trial in 2018, with a minimal difference in regional or demographic practice patterns. Overall, the publication of the CARMENA trial results is seemingly associated with substantial alteration of clinical practice in the USA, with relatively broad and nonspecific adoption across facilities, regions, and demographics.</p><p><strong>Patient summary: </strong>For decades, the immediate surgical removal of the kidney tumor (cytoreductive nephrectomy) was a mainstay of metastatic kidney cancer treatment. In 2018, the CARMENA study showed that patients treated with systemic therapy alone had similar outcomes to patients who underwent cytoreductive nephrectomy first. In this study, we show that fewer cytoreductive nephrectomies were performed after the CARMENA trial results were published.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Effectiveness of Bacillus Calmette-Guérin and Sequential Intravesical Gemcitabine and Docetaxel for Treatment-naïve Intermediate-risk Non-muscle-invasive Bladder Cancer.","authors":"Kaushik P Kolanukuduru, Reuben Ben-David, Sarah Lidagoster, Mohammed Almoflihi, Neeraja Tillu, Ahmed Eraky, Parissa Alerasool, Nikhil Waigankar, Kyrollis Attalla, Reza Mehrazin, Peter Wiklund, John P Sfakianos","doi":"10.1016/j.euf.2024.09.006","DOIUrl":"https://doi.org/10.1016/j.euf.2024.09.006","url":null,"abstract":"<p><strong>Background and objective: </strong>Sequential intravesical gemcitabine/docetaxel (Gem/Doce) has emerged as a potential alternative to bacillus Calmette-Guérin (BCG) for the treatment of non-muscle-invasive bladder cancer (NMIBC). Our aim was to determine the comparative effectiveness of BCG and Gem/Doce for patients with intermediate-risk (IR) NMIBC, composed mainly of high-grade (HG) Ta disease.</p><p><strong>Methods: </strong>Patients with IR-NMIBC who received either BCG or Gem/Doce during 2013-2023 were included. Maintenance BCG (as per the Southwest Oncology Group protocol) and monthly Gem/Doce maintenance for 1 yr were offered to patients with no evidence of recurrence after induction. Routine surveillance with cystoscopy was performed according to the American Urological Association guidelines. The Kaplan-Meier method was used to assess high-grade and any-grade recurrence-free survival (RFS). Cox regression analysis was performed to find predictors of recurrence.</p><p><strong>Key findings and limitations: </strong>Of 483 patients, 127 had IR-NMIBC; 66 patients received BCG and 61 received Gem/Doce. Median age was 69 yr (interquartile range [IQR] 61-76) for the BCG group and 72 yr (IQR 62-76) for the Gem/Doce group. Median follow-up was 53.1 mo (IQR 25.3-71.2) for the BCG group and 20.2 mo (IQR 8.28-33.1) for the Gem/Doce group. The 2-yr high-grade RFS rates for primary high-grade tumors for BCG versus Gem/Doce groups were 81% versus 61%, with corresponding any-grade RFS rates of 60% versus 41%. Induction with Gem/Doce predicted any-grade recurrence (hazard ratio [HR] 1.87, 95% confidence interval [CI] 1.1-3.2) and high-grade recurrence for primary high-grade tumors (HR 3.4 95% CI 1.27-9.13), while receipt of maintenance therapy decreased the risk of any-grade recurrence (HR 0.4, 95% CI 0.22-0.72). This study is limited by its retrospective design.</p><p><strong>Conclusions and clinical implications: </strong>For patients with IR-NMIBC, BCG was associated with superior any-grade RFS and high-grade RFS for primary high-grade tumors. Maintenance therapy was associated with better RFS when receiving Gem/Doce. Standardization and longer maintenance therapy protocols should be considered for Gem/Doce treatment.</p><p><strong>Patient summary: </strong>We compared outcomes for patients who received two different in-bladder treatments for intermediate-risk bladder cancer. Bacillus Calmette-Guérin (BCG) led to better outcomes than gemcitabine + docetaxel (Gem/Doce). Monthly maintenance therapy improved recurrence-free survival for patients who received Gem/Doce. We conclude that maintenance therapy is essential for patients receiving Gem/Doce to avoid bladder cancer recurrence after treatment.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning Curve for Single-port Robot-assisted Urological Surgery: Single-center Experience and Implications for Adoption.","authors":"Antony A Pellegrino, Francesco Pellegrino, Donato Cannoletta, Ruben Sauer Calvo, Juan Torres Anguiano, Luca Morgantini, Alberto Briganti, Francesco Montorsi, Simone Crivellaro","doi":"10.1016/j.euf.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.euf.2024.09.005","url":null,"abstract":"<p><strong>Background and objective: </strong>Understanding the learning curve for the da Vinci single-port (SP) surgical robot is crucial for adoption, training, and enhancement of surgical safety and efficiency. Our aim was to assess the impact of both overall experience (O-EXP) and procedure-specific experience (PS-EXP) on perioperative outcomes across various SP surgeries.</p><p><strong>Methods: </strong>We analyzed data for 387 consecutive SP surgeries conducted by a high-volume surgeon from December 2018 to July 2023. These included SP robot-assisted radical prostatectomy (SP-RARP), robot-assisted simple prostatectomy (SP-RASP), and robot-assisted nephrectomy (SP-RANP). We used multivariable logistic regression to evaluate the relationship between surgeon experience and outcomes, and locally weighted scatterplot smoothing analysis to graphically explore the risk of postoperative complications according to O-EXP.</p><p><strong>Key findings and limitations: </strong>The 387 SP procedures assessed included 172 (44%) SP-RARP, 53 (14%) SP-RASP, and 162 (42%) SP-RANP cases. Overall, 17% of patients had a complication of any grade, 6% experienced severe complications (Clavien-Dindo grade ≥3), and 8% required readmission. Both O-EXP and PS-EXP were associated with a lower risk of complications. The odds ratios for the incidence of complications per increment of 10 procedures were 0.83 (95% confidence interval [CI] 0.76-0.89) for PS-EXP and 0.93 (95% CI 0.90-0.96) for O-EXP. PS-EXP was also associated with a shorter operative time (β = -3.9, 95% CI -4.9 to -2.9). The risk of complications reached a minimum at 30 SP-RASP, 70 SP-RANP, and 150 SP-RARP cases. Our study is limited by its retrospective design, single-surgeon experience, and lack of functional outcome assessment.</p><p><strong>Conclusions and clinical implications: </strong>Robot-assisted surgery with the da Vinci SP robot has a distinctive learning curve that is influenced by the platform and procedure-specific characteristics. For surgeons new to SP surgery, RASP and renal procedures had the earliest learning curve success and should be approached first, with RARP attempted only when the surgeon has become accustomed to the SP platform.</p><p><strong>Patient summary: </strong>We investigated the learning curve for a surgical robot that uses just one keyhole incision. We found that the time to reach proficiency for urological surgeries with this specific robot, measured as the rate of complications, is faster for some procedures than for more complex operations. This information can help in improving surgeon training and patient safety.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stapled W-shaped (Hautmann) Orthotopic Ileal Neobladder. Functional Results and Complications over a 13-year Period.","authors":"Angelo Cormio,Nicola d'Altilia,Beppe Calò,Ugo Giovanni Falagario,Francesco Cinelli,Vito Mancini,Gian Maria Busetto,Carlo Bettocchi,Giuseppe Carrieri,Luigi Cormio","doi":"10.1016/j.euf.2024.09.002","DOIUrl":"https://doi.org/10.1016/j.euf.2024.09.002","url":null,"abstract":"BACKGROUND AND OBJECTIVEThe preferable technique for orthotopic bladder substitution after radical cystectomy is debated. The aim of this study was to describe our technique of a stapled W-shaped ileal neobladder and assess the complications and functional results in 100 patients. treated from December 2009 to July 2022.METHODSThe W-shaped ileal neobladder is created with lateral arms of 15 cm and central arms of 10 cm. Following an incision of the lower part of the two medial arms, a 10-cm GIA titanium stapler is used to detubularize the medial arms first and then the laterals to the medial arms. Urethral-neobladder anastomosis and end-to-end ureteroileal anastomosis are finally carried out. We reported on clinical data, complications, and urinary function outcomes assessed by the International Consultation on Incontinence Questionnaire (ICIQ)-Short Form and daytime/24-h pad test. Full urinary continence (UC) was defined as pad tests yielding 0 g.KEY FINDINGS AND LIMITATIONSThe median surgical time was 210 min. The early (up to 90 d) and late (>90 d) complication rates were 18% (2% grade ≥4) and 11.7% (2% grade ≥4), respectively. Two patients had \"late\" bladder stones due to chronic urinary retention, whereas none developed calcifications in the neobladder along the stapling lines. Daytime and 24-h UC rates were 74.7% and 72.4% at 12 mo, 82.7% and 72.4% at 36 mo, respectively. Median ICIQ scores were in line with pad test results, being 0 in patients with full UC.CONCLUSIONS AND CLINICAL IMPLICATIONSOur stapled W-shaped ileal neobladder technique was found to be simple and fast to shape, with a low complication rate, and yielded favorable long-term functional outcomes.PATIENT SUMMARYThis study details the surgical technique, complications, and functional outcomes of patients who underwent open cystectomy with a stapled W-shaped ileal neobladder. Our results indicate that this approach is safe and provides favorable long-term functional outcomes.","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upfront Versus Deferred Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma: A Systematic Review and Individual Patient Data Meta-analysis.","authors":"Stepan M Esagian,Jose A Karam,Pavlos Msaouel,Dimitrios Makrakis","doi":"10.1016/j.euf.2024.08.002","DOIUrl":"https://doi.org/10.1016/j.euf.2024.08.002","url":null,"abstract":"BACKGROUND AND OBJECTIVEDespite its well-established role in metastatic renal cell carcinoma (mRCC), the optimal timing of cytoreductive nephrectomy (CN) is unclear. The aim of this systematic review is to compare the overall survival (OS) between upfront (uCN) and deferred (dCN) CN.METHODSThe MEDLINE, EMBASE, and Web of Science databases were queried (end of search date: August 26, 2023) for studies comparing OS between uCN and dCN in mRCC patients. We reconstructed individual patient data from published Kaplan-Meier survival curves and performed one- and two-stage meta-analyses, using 6- and 12-mo landmarks to mitigate immortal time bias. We also performed subgroup analyses according to systemic therapy (ST) type and Memorial Sloan Kettering Cancer Center (MSKCC)/International Metastatic RCC Database Consortium (IMDC) risk scores. We assessed the risk of bias using the Risk of Bias in Non-randomized Studies of Interventions and Risk of Bias 2.0 tools.KEY FINDINGS AND LIMITATIONSWe identified 12 (two randomized trials and ten retrospective cohorts) eligible studies with a total of 3323 (2610 uCN and 713 dCN) patients. There were no statistically significant differences in the baseline characteristics of the two groups, other than the number of metastases and ST type. The overall risk of bias was high in nine out of 12 studies. Deferred CN was associated with superior OS in the primary analysis (hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.65-0.84; 5-yr life expectancy difference 5.15 mo, 95% CI 3.23-7.08), all secondary analyses, as well as the tyrosine kinase inhibitor-treated (HR 0.61, 95% CI 0.51-0.74), immune checkpoint inhibitor-treated (HR 0.67, 95% CI 0.46-0.97), and intermediate IMDC/MSKCC risk (HR 0.73, 95% CI 0.55-0.97) subgroups.CONCLUSIONS AND CLINICAL IMPLICATIONSDeferred CN is associated with superior OS compared with uCN in mRCC patients treated with contemporary STs. Randomized studies are warranted to confirm these findings. Predictive models are needed to optimize the selection of patients most likely to benefit from dCN.PATIENT SUMMARYIn this report, we compared the outcomes of nephrectomy performed before (upfront) or after (deferred) starting systemic therapy for patients with metastatic kidney cancer. We found that deferred nephrectomy is associated with superior survival compared with upfront nephrectomy, irrespective of the systemic therapy regimens used.","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic and Laparoscopic Adrenalectomy for Pheochromocytoma: An International Multicenter Study.","authors":"Alessandro Parente, Kevin Verhoeff, Yanbo Wang, Nanya Wang, Zhicheng Wang, Maciej Śledziński, Andrzej Hellmann, Marco Raffaelli, Francesco Pennestrì, Mark Sywak, Alexander J Papachristos, Fausto F Palazzo, Tae-Yon Sung, Byung-Chang Kim, Yu-Mi Lee, Fiona Eatock, Hannah Anderson, Maurizio Iacobone, Albertas Daukša, Ozer Makay, Yigit Turk, Hafize Basut Atalay, Els J M Nieveen van Dijkum, Anton F Engelsman, Isabelle Holscher, Gabriele Materazzi, Leonardo Rossi, Chiara Becucci, Susannah L Shore, Clare Fung, Alison Waghorn, Radu Mihai, Sabapathy P Balasubramanian, Arslan Pannu, Shuichi Tatarano, David Velázquez-Fernández, Julie A Miller, Hazel Serrao-Brown, Yufei Chen, Marco Stefano Demarchi, Reza Djafarrian, Helen Doran, Kelvin Wang, Michael J Stechman, Helen Perry, Johnathan Hubbard, Cristina Lamas, Philippa Mercer, Janet MacPherson, Supanut Lumbiganon, María Calatayud, Felicia Alexandra Hanzu, Oscar Vidal, Marta Araujo-Castro, Cesar Minguez Ojeda, Theodosios Papavramidis, Pablo Rodríguez de Vera Gómez, Abdulaziz Aldrees, Tariq Altwjry, Nuria Valdés, Cristina Álvarez-Escola, Iñigo García Sanz, Concepción Blanco Carrera, Laura Manjón-Miguélez, Paz De Miguel Novoa, Mónica Recasens, Rogelio García Centeno, Cristina Robles Lázaro, Klaas Van Den Heede, Sam Van Slycke, Theodora Michalopoulou, Sebastian Aspinall, Ross Melvin, Joel Wen Liang Lau, Wei Keat Cheah, Man Hon Tang, Han Boon Oh, John Ayuk, Robert P Sutcliffe","doi":"10.1016/j.euf.2024.09.001","DOIUrl":"https://doi.org/10.1016/j.euf.2024.09.001","url":null,"abstract":"<p><strong>Background and objective: </strong>Robotic adrenalectomy (RA) has attracted interest as an alternative to laparoscopic adrenalectomy (LA) for patients with pheochromocytoma, although its beneficial effects are uncertain. Our aim was to compare RA and LA outcomes for these patients.</p><p><strong>Methods: </strong>Data for patients who underwent RA or LA for pheochromocytoma in 46 international centers between 2012 and 2022 were reviewed. We analyzed baseline characteristics and postoperative complications at discharge, 90 d, and 1 yr. We conducted propensity score matching (PSM; 1:1 ratio) and multivariable analyses to evaluate outcomes and risk factors for the occurrence of complications and higher Comprehensive Complication Index (CCI).</p><p><strong>Key findings and limitations: </strong>Of 1755 patients, 1613 (91.9%) underwent LA and 142 (8.1%) underwent RA. Estimated blood loss, conversion rate, complication rate, and CCI at discharge, 90 d, and 1 yr were similar between the groups. However, RA was associated with a longer operative time in comparison to LA (100 vs 123 min; p < 0.001), but not after PSM (p = 0.120). Multivariable analysis revealed that Charlson comorbidity index (odds ratio [OR] 1.17, 95% confidence interval [CI] 1.07-1.29; p = 0.001), and tumor size per 1-cm increment (OR 1.13, 95% CI 1.07-1.21; p < 0.001) were independently associated with the incidence of complications, but there was no significant difference in complication rates between the LA and RA groups (OR 1.09, 95% CI 0.63-1.87; p = 0.767). After PSM, RA was associated with a lower rate of severe (grade ≥3a) complications in comparison to LA (p = 0.023).</p><p><strong>Conclusions and clinical implications: </strong>RA is a safe alternative to LA and yields similar outcomes for patients with pheochromocytoma. RA may be associated with a lower likelihood of severe complications. Further studies are warranted to determine the role of robotic surgery in pheochromocytoma.</p><p><strong>Patient summary: </strong>Pheochromocytoma is a rare tumor in the adrenal gland and the gold-standard treatment is surgical removal. We assessed patient outcomes after robot-assisted surgery compared with laparoscopic surgery and found that outcomes are similar, but the rate of severe complications may be lower if a surgical robot is used.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Kaushik P. Kolanukuduru, Michael Gorin, Ash K. Tewari, and Mani Menon's Letter to the Editor re: Alec Zhu, Mary O. Strasser, Timothy D. McClure, et al. Comparative Effectiveness of Partial Gland Cryoablation Versus Robotic Radical Prostatectomy for Cancer Control. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2024.04.008.","authors":"Mary O Strasser,Alec Zhu,Jim C Hu","doi":"10.1016/j.euf.2024.08.006","DOIUrl":"https://doi.org/10.1016/j.euf.2024.08.006","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":5.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142267749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycomimetics as Candidates for Treatment and Prevention of Catheter-associated Biofilms Formed by Pseudomonas aeruginosa.","authors":"Christian Vogel, Katharina Rox, Florian Wagenlehner, Alexander Titz","doi":"10.1016/j.euf.2024.08.011","DOIUrl":"https://doi.org/10.1016/j.euf.2024.08.011","url":null,"abstract":"<p><p>Bacteria develop biofilms for protection and persistent colonization. Biofilms of pathogenic bacteria can lead to serious medical problems. Bacterial biofilms on catheters used in the treatment of urinary tract diseases represent a major challenge for antibiotic therapy. Several attempts to eradicate biofilms using classical antibiotics and various alternatives, including antibiotic treatment of surfaces, surfaces that release silver ions, and surfaces with anti-adhesive properties, have not shown clinical efficacy in biofilm prevention or removal. Pseudomonas aeruginosa is one of the most problematic biofilm-forming uropathogens and accounts for approximately 10% of urinary tract infections. Novel glycomimetics that inhibit bacterial lectins have shown promising results in the prevention of P. aeruginosa biofilms and in interference with bacterial virulence. This mini-review summarizes the status of glycomimetic development and provides a perspective on their use in clinical practice. PATIENT SUMMARY: For patients with recurrent urinary tract infections and patients needing long-term catheter use to manage urinary problems, biofilms formed by bacteria can be a problem and are difficult to treat. New compounds that mimic carbohydrates, called glycomimetics, have shown promise in inhibiting these bacteria and the biofilms they form. More research on these compounds is needed before they can be used to treat patients.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PARP Inhibitor Addition to Androgen Receptor Pathway Inhibitors in Metastatic Castration-resistant Prostate Cancer Should Be Limited to BRCA Mutation Carriers.","authors":"Elena Castro","doi":"10.1016/j.euf.2024.08.005","DOIUrl":"https://doi.org/10.1016/j.euf.2024.08.005","url":null,"abstract":"<p><p>For patients with metastatic castration-resistant prostate cancer whose tumors harbor BRCA1/2 alterations, the potential benefits of combining a PARP inhibitor and an androgen receptor pathway inhibitor for first-line treatment outweigh the potential side effects. Further research is required to identify patients without detectable BRCA1/2 defects who would benefit from this approach.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}