European urology focus最新文献

{"title":"Clinical Applications of Microbiome in Renal Cell Carcinoma.","authors":"Sara Elyas, Pedro Barata, Ulka Vaishampayan","doi":"10.1016/j.euf.2024.12.006","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.006","url":null,"abstract":"<p><p>Advancements in microbiome research reveal its impact on cancer treatment outcomes, particularly in renal cell carcinoma (RCC). While immune checkpoint inhibitors (ICIs) have improved survival in metastatic RCC, composition of the gut microbiome has the potential to influence their efficacy. Antibiotic-induced microbiome disruptions correlate with diminished outcomes, while strains such as Akkermansia muciniphila, Clostridium butyricum, and others enhance immune responses and progression-free survival. Some prebiotics such as inulin gel can alter the gut flora to overcome the resistant strains occurring in response to immune therapy. This mini-review explores microbiome-targeted interventions, such as pre/probiotics and fecal microbiota transplantation, for overcoming ICI resistance. Although promising, prospective randomized trials are needed to standardize clinical applications and optimize microbiome-targeted treatments. The standard use of gut-modulating therapy cannot be recommended at present outside of clinical trials. A double-blind placebo-controlled randomized trial of ICI ± gut modulating therapy is being planned in frontline therapy of advanced RCC (BIOFRONT trial by the Southwest Oncology Group).</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002847","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":"Best Practice Guidelines for Collecting Microbiome Samples in Research Studies.","authors":"Ilaha Isali, Thomas R Wong, Shari Tian","doi":"10.1016/j.euf.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.007","url":null,"abstract":"<p><p>Microbiome research has the potential to provide valuable information regarding the complex relationship between microbial communities and the human body. To help facilitate the translation of this potentially revolutionary research to clinical medicine, common guidelines and best practices are necessary. These guidelines should be based on the key findings of recent research in the field and address the primary areas of discrepancy in the previously published literature. Based on this review's findings, future microbiome research should adopt a consistent and clear approach to nomenclature, using standardized terminology to mitigate confusion. Additionally, only sample collection methods proven to reduce the risk of contamination should be utilized. While sample storage often creates difficulty in microbiome research, there are proven techniques that can improve results. With the wide array of research methodologies in the literature, standardization of metadata collection, kits, and analysis software could also be beneficial. Finally, documentation and records are critical in ensuring reproducibility, as is the case with all basic research. This brief review provides a foundation for evidence-based guidelines in microbiome research. PATIENT SUMMARY: This report outlines general guidelines and best practices for conducting microbiome research, which could significantly advance the field of medicine.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983218","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: Rong Dai and Changkai Deng's Letter to the Editor re: Anirban Dey, Georgios Georgiadis, Justin Umezurike, et al. Mirabegron Versus Placebo and Other Therapeutic Modalities in the Treatment of Patients with Overactive Bladder Syndrome-A Systematic Review. Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2024.09.012.","authors":"Anirban Dey, Georgios Georgiadis, Justin Umezurike, Yuhong Yuan, Fawzy Farag, James N'Dow, Muhammad Imran Omar, Charalampos Mamoulakis","doi":"10.1016/j.euf.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.004","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946989","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":"Reimagining Male Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia Treatment: A New Approach to First-line Interventional Therapy.","authors":"Dean Elterman, Steven A Kaplan","doi":"10.1016/j.euf.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.008","url":null,"abstract":"<p><p>Benign prostatic hyperplasia is a prevalent condition leading to male lower urinary tract symptoms (mLUTS), particularly in aging populations. Current management strategies-spanning watchful waiting, pharmaceutical therapy, and surgical interventions such as transurethral resection of the prostate-face significant limitations, including side effects, low adherence, and patient hesitancy toward invasive treatments. First-line interventional therapy (FIT) emerges as a novel paradigm bridging the gap between medications and surgery. FIT aims to provide effective, minimally invasive symptom relief with rapid recovery, minimal side effects, and preserved treatment adaptability. Recent advancements in minimally invasive surgical therapies (MISTs) highlight potential; yet existing MIST procedures often fall short of meeting the FIT criteria. An ideal FIT would integrate outpatient feasibility, durability, and patient-centered outcomes, addressing both urologist and patient expectations. By reimagining treatment pathways, FIT has the potential to revolutionize mLUTS management, shifting the standard of care toward early, effective, and patient-friendly interventions, ultimately improving quality of life and long-term bladder health. PATIENT SUMMARY: In this report, we explored new treatment options for men with urinary symptoms caused by an enlarged prostate. We found that many men avoid surgery due to its risks and side effects, while medications often have limited success and unwanted effects. We suggest a new type of treatment, called first-line interventional therapy, which could provide faster symptom relief with fewer risks and quicker recovery, offering a better option for many patients.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946987","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 Laila Schneidewind, Fabian P. Stangl, Jennifer Kranz, and Gernot Bonkat's Letter to Editor re: Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero. Quinolone Prophylaxis in Conjunction with Bacillus Calmette-Guérin Instillations for Bladder Cancer: Time To Reconsider the Evidence and Open the Quinolone Box? Eur Urol Focus 2024;10:564-6.","authors":"Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero","doi":"10.1016/j.euf.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.euf.2024.12.001","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853378","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":"Re: Anirban Dey, Georgios Georgiadis, Justin Umezurike, et al. Mirabegron Versus Placebo and Other Therapeutic Modalities in the Treatment of Patients with Overactive Bladder Syndrome-A Systematic Review. Eur Urol Focus. In press. https://doi:10.1016/j.euf.2024.09.012.","authors":"Rong Dai, Changkai Deng","doi":"10.1016/j.euf.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.euf.2024.11.013","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846285","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":"Re: Fredrik Liedberg, Evanguelos Xylinas, Paolo Gontero. Quinolone Prophylaxis in Conjunction with Bacillus Calmette-Guérin Instillations for Bladder Cancer: Time To Reconsider the Evidence and Open the Quinolone Box? Eur Urol Focus. In press. https://doi.org/10.1016/j.euf.2023.11.007.","authors":"Laila Schneidewind, Fabian P Stangl, Jennifer Kranz, Gernot Bonkat","doi":"10.1016/j.euf.2024.10.012","DOIUrl":"https://doi.org/10.1016/j.euf.2024.10.012","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824045","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":"Cytoreductive Nephrectomy in Metastatic Renal Cell Carcinoma Treated with Immune Checkpoint Inhibitors: A Systematic Review and Meta-analysis of Individual Patient Data.","authors":"Dimitrios Makrakis, Pavlos Msaouel, Jose A Karam, Stepan Μ Esagian","doi":"10.1016/j.euf.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.euf.2024.11.007","url":null,"abstract":"<p><strong>Background and objective: </strong>The role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC) in the era of immune checkpoint inhibitors (ICIs) is controversial. We aimed to investigate the survival benefit of CN in patients with mRCC treated with ICIs.</p><p><strong>Methods: </strong>We searched the EMBASE, MEDLINE, and Web of Science databases up to August 26, 2023 to identify studies comparing overall survival (OS) for patients with mRCC treated with ICIs with or without CN. We reconstructed individual patient data using published Kaplan-Meier curves and performed one- and two-stage meta-analyses using 6-mo and 12-mo landmarks to control for immortal time bias. We also performed subgroup analyses for patients treated with first-line ICI or upfront CN.</p><p><strong>Key findings and limitations: </strong>We identified eight eligible studies involving a total of 2319 patients. There were statistically significant differences in baseline characteristics (age, clear cell histology, International mRCC Database Consortium scores) between the ICI + CN and ICI-alone groups. Combined CN + ICI therapy was associated with superior OS in the primary analysis (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.37-0.54) and secondary analyses, and in subgroup analyses for patients receiving first-line ICI therapy (HR 0.39, 95% CI 0.30-0.48) and upfront CN (HR 0.52, 95% CI 0.40-0.69).</p><p><strong>Conclusions and clinical implications: </strong>CN combined with ICI therapy in mRCC may be associated with superior OS. Further studies are needed to confirm this finding and identify the patients most likely to benefit from CN in this setting.</p><p><strong>Patient summary: </strong>We compared outcomes after immune checkpoint inhibitor (ICI) therapy, which boosts the immune system to fight cancer, with or without nephrectomy (surgical removal of the kidney) in patients with metastatic kidney cancer. We found that the combination of nephrectomy and ICI therapy was associated with better survival than just ICI therapy.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817634","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":"Assessing the Molecular Heterogeneity of Prostate Cancer Biopsy Sampling: Insights from the MAST Trial.","authors":"Tarek Ajami, Hui Yu, Joao G Porto, Nachiketh Soodana Prakash, Adam Williams, Yuval Avda, Ankur Malpani, Dinno F Mendiola, Pedro F S Freitas, Archan Khandekar, Sanjaya Swain, Sandra Gaston, Brandon Mahal, Elena Cortizas, Zoe Szczotka, Timothy Gerard, Bruce Kava, Radka Stoyanova, Oleksandr N Kryvenko, Patricia Castillo, Chad R Ritch, Bruno Nahar, Mark L Gonzalgo, Alan Pollack, Dipen J Parekh, Sanoj Punnen","doi":"10.1016/j.euf.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.euf.2024.11.012","url":null,"abstract":"<p><strong>Background and objective: </strong>Prostate cancer (PC) heterogeneity can result in sampling discrepancies during biopsy, leading to inaccurate molecular classifications that affect treatment decisions. We evaluated transcriptomic profile variability between multiparametric magnetic resonance imaging (mpMRI)-targeted biopsy (TBx) and systematic biopsy (SBx) methods using the Decipher GRID platform.</p><p><strong>Methods: </strong>The study included 205 men from the MAST trial. We analyzed 408 biopsy samples, of which 149 were TBx and 259 were SBx samples. Three prognostic signatures-the Decipher genomic classifier (DGC), cell cycle progression (CCP), and Genomic Prostate Score-were assessed in relation to grade group (GG) and MRI phenotype. Multivariable linear regression was conducted to adjust for the confounding effects of GG and tumor purity.</p><p><strong>Key findings and limitations: </strong>Unpaired analysis revealed that TBx samples had higher derived GPS and CCP scores than SBx samples (p < 0.05), but the difference was no longer significant after multiple-test adjustment. There was no significant difference in scores between SBx and TBx samples in the subgroup with GG 1 disease. For TBx cores, higher genomic scores were associated with higher Prostate Imaging-Reporting and Data System (PI-RADS) scores in the overall cohort, but not in the GG 1 subgroup. Multivariable analysis revealed significant associations between DGC and CCP scores and PI-RADS scores (p < 0.01). Higher DGC score concordance between TBx and SBx lesions was observed in the low-risk subgroup. A limitation of the study is the small sample size, so further validation is required.</p><p><strong>Conclusions and clinical implications: </strong>TBx samples yield higher genomic scores than SBx samples, with grade influencing the association between PI-RADS score and genomic risk. For the GG 1 subgroup, there was no correlation between PI-RADS and genomic scores. These findings need further validation to assess the impact of TBx on genomic risk assessment in active surveillance.</p><p><strong>Patient summary: </strong>We examined the effectiveness of two different biopsy methods in assessing the risk of prostate cancer (PC) progression. We found that while biopsy samples guided by MRI (magnetic resonance imaging) scans often showed higher genetic risk scores than biopsy samples without MRI guidance, the difference was not significant for men with lower-grade PC. Our findings suggest that MRI targeting for biopsy might not always provide additional information about cancer aggressiveness for patients with low-risk PC.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812400","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":"Mechanism of Nephrolithiasis: Does the Microbiome Play a Role?","authors":"Jose Agudelo, Sromona Mukherjee, Mangesh Suryavanshi, Bernardita Ljubetic, Marcelo Mass Lindenbaum, Aaron W Miller","doi":"10.1016/j.euf.2024.11.010","DOIUrl":"https://doi.org/10.1016/j.euf.2024.11.010","url":null,"abstract":"<p><p>Nephrolithiasis imposes a significant health care burden around the world. In the past decade, there has been considerable interest in the human microbiota in relation to the onset of nephrolithiasis. Most of the research has focused on degradation of oxalate, a known causative factor for nephrolithiasis, by bacteria in the gut. More recently, the role of antibiotic exposure and changes to short-chain fatty acids have been investigated. Studies have revealed that the urinary tract, previously thought to be sterile, harbors resident microbial communities closely associated with nephrolithiasis. In this mini-review, we evaluate potential causative roles of the microbiome in the onset of nephrolithiasis and the development of novel therapies to prevent this disease. PATIENT SUMMARY: This mini-review discusses scientific evidence on the influence of bacteria in our intestines and urinary tract on the formation of kidney stones. We discuss possible therapies targeting these bacteria that could prevent kidney stones from forming.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812402","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}