European urology focus最新文献

{"title":"Single-port Robotic Retroperitoneal Partial Nephrectomy via Low Anterior Access: A Propensity-matched Comparative Analysis to Standard Transperitoneal Multiport Robotic Surgery from the Single Port Advanced Research Consortium (SPARC)","authors":"Nicolas A. Soputro,&nbsp;Sonam Saxena,&nbsp;Jewel Bamby,&nbsp;Arianna Biasatti,&nbsp;Francesco Aguirre,&nbsp;Ruben Sauer Calvo,&nbsp;Gabriela Nieto-Blanco,&nbsp;Rasheed Thompson,&nbsp;Kennedy E. Okhawere,&nbsp;Graham Kupsaw,&nbsp;Abdulrahman Al-Bayati,&nbsp;Sarah Duncan,&nbsp;Gianna Jimenez,&nbsp;Dattatraya Patil,&nbsp;Shamsunnahar Imtiaz,&nbsp;C.Adam Lorentz,&nbsp;Jennifer A. Linehan,&nbsp;Simone Crivellaro,&nbsp;Srinivas Vourganti,&nbsp;Riccardo Autorino,&nbsp;Jihad Kaouk","doi":"10.1016/j.euf.2025.12.008","DOIUrl":"10.1016/j.euf.2025.12.008","url":null,"abstract":"<div><h3>Background and objective</h3><div>The introduction of the purpose-built single-port (SP) robotic platform has paved the way for the development of regionalized surgical approaches, as evident by the advent of low anterior access (LAA) SP retroperitoneal robot-assisted partial nephrectomy (rRAPN). Our aim was to evaluate perioperative outcomes of LAA SP-rRAPN in comparison to the standard transperitoneal multiport (MP) robotic approach.</div></div><div><h3>Methods</h3><div>We performed a retrospective review of the institutional review board–approved, prospectively maintained database of the SP Advanced Research Consortium (SPARC) to identify all consecutive patients who underwent RAPN between 2015 and 2025. We applied 1:1 propensity score matching (PSM) for analysis to ensure comparable baseline characteristics, including comorbidities, renal function, and tumor complexity.</div></div><div><h3>Key findings and limitations</h3><div>Of 2306 patients, our PSM analysis included 302 LAA SP-rRAPN cases and 302 MP-RAPN cases. Following PSM, the two cohorts demonstrated comparable operative time, estimated blood loss, surgical margin status, and incidence of major postoperative complications. A history of abdominal surgery was more common in the SP group (55.1% vs MP 42.7%; <em>p</em> = 0.005). Postoperatively, the SP cohort had significantly shorter hospital stay (&lt;24 h: SP 41.6% vs MP 10.9%; <em>p</em> &lt; 0.001), lower postoperative pain (median highest pain score: SP 5 vs MP 6; <em>p</em> &lt; 0.001), and less frequent need for opioids (SP 46.3% vs MP 93.1%; <em>p</em> &lt; 0.001). Notably, no SP patients experienced postoperative ileus or respiratory complications such as atelectasis, pleural effusion, or pneumonia.</div></div><div><h3>Conclusions and clinical implications</h3><div>This study highlights the safety and efficacy of LAA SP-rRAPN, which has perioperative outcomes comparable to those for the transperitoneal MP robotic approach. Moreover, LAA SP-rRAPN offers additional benefits, including enhanced postoperative recovery with lower morbidity, and provides a viable surgical alternative for patients with complex abdominal surgical history.</div></div>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 4","pages":"Pages 735-742"},"PeriodicalIF":6.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145818649","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":"The Prostate Resection Versus Minimally Invasive Surgery Evaluation Trial (PREMISE Trial) and Why We Need It","authors":"Toby Page,&nbsp;Marcus Drake,&nbsp;Naomi McGregor","doi":"10.1016/j.euf.2026.05.003","DOIUrl":"10.1016/j.euf.2026.05.003","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 4","pages":"Pages 633-635"},"PeriodicalIF":6.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148005116","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":"Time-dependent Treatment Effects of Prostate-specific Membrane Antigen Radioligand Therapy in Metastatic Castration-resistant Prostate Cancer in the ENZA-p (ANZUP1901) Trial","authors":"Wei Chen,&nbsp;Soichiro Yoshida,&nbsp;Koichiro Kimura,&nbsp;Yuki Arita,&nbsp;Yasuhisa Fujii","doi":"10.1016/j.euf.2025.11.019","DOIUrl":"10.1016/j.euf.2025.11.019","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 4","pages":"Pages 813-816"},"PeriodicalIF":6.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713842","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: Piet Ost, Shankar Siva, Sigmund Brabrabd, et al. Salvage Metastasis-directed Therapy Versus Elective Nodal Radiotherapy for Oligorecurrent Nodal Prostate Cancer Metastases (PEACE V–STORM): A Phase 2, Open-label, Randomised Controlled Trial. Lancet Oncol 2025;26:695–706","authors":"André N. Vis,&nbsp;Roderick C.N. van den Bergh","doi":"10.1016/j.euf.2025.06.020","DOIUrl":"10.1016/j.euf.2025.06.020","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":"12 4","pages":"Pages 818-819"},"PeriodicalIF":6.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642137","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: Stangl FP, Day E, Vallée M, et al. Infectious Complications After Transrectal Versus Transperineal Prostate Biopsy: A Aystematic Review and Meta-analysis. Eur Urol Focus 2026;12:275-83.","authors":"Xin Li, Yapeng Xing","doi":"10.1016/j.euf.2026.08.006","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.006","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857115","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":"Oncological Outcomes of Robot-assisted PSMA-guided Salvage Surgery in Recurrent Prostate Cancer: Insights from the Prospective TRACE-I Trial.","authors":"Lotte G Zuur, Hilda A de Barros, Vera A Ottens, Anne-Claire Berrens, Matthias N van Oosterom, Maarten L Donswijk, Jeroen J M A Hendrikx, Fijs W B van Leeuwen, Henk G van der Poel, Pim J van Leeuwen","doi":"10.1016/j.euf.2026.07.005","DOIUrl":"https://doi.org/10.1016/j.euf.2026.07.005","url":null,"abstract":"<p><strong>Background: </strong>Prostate-specific membrane antigen (PSMA)-radioguided surgery (RGS) is an emerging technique providing real-time intraoperative guidance. The prospective TRACE-I trial demonstrated that robot-assisted ^99mtechnetium-PSMA-Investigation & Surgery-RGS ([^99mTc]Tc-PSMA-I&S-RGS) using a DROP-IN gamma probe is feasible and safe in recurrent prostate cancer (PCa).</p><p><strong>Objective: </strong>To report the oncological outcmes of a post hoc analysis of the prospective TRACE-I trial cohort.</p><p><strong>Design, setting, and participants: </strong>TRACE-I prospectively enrolled 30 patients with biochemical recurrence (prostate-specific antigen (PSA) ≥0.2 ng/ml after radical prostatectomy (RP) or ≥2 ng/ml above nadir after radiotherapy (RT) and ≤3 pelvic recurrences (nodal and/or local) on PSMA-positron emission tomography/computed tomography (PET/CT; 2020-2023).</p><p><strong>Intervention: </strong>Patients underwent single-photon emission CT/CT and then robot-assisted PSMA-RGS.</p><p><strong>Outcomes measurements and statistical analysis: </strong>Oncological outcomes were biochemical progression (PSA ≥0.2 ng/ml after RP or ≥2 ng/ml above nadir after RT), radiological recurrence on PSMA-PET/CT, and time to salvage therapy. Biochemical progression-free survival (bPFS), distant metastasis-free survival (dMFS), and therapy-free survival (TFS) were analysed using Kaplan-Meier and univariable Cox regression.</p><p><strong>Results and limitations: </strong>Among 30 patients (19 RP, 9 RT, and 2 RP + RT), the median age was 68 yr, and the median PSA at RGS was 1.02 ng/ml (interquartile range, 0.46-2.86), 28 (93%) showed PSA decline after RGS, and 20 (66%) reached PSA <0.2 ng/ml or PSA nadir. The 1- and 2-yr bPFS were 40% and 30%; 2-yr dMFS and TFS were 62% and 58%, respectively. Recurrences were pelvic in 37% and distant in 40%. Limitations include single-centre design and small sample size.</p><p><strong>Conclusions: </strong>PSMA-RGS in the robotic setting for recurrent PCa shows an early PSA decline in almost all patients. Although biochemical progression after PSMA-RGS is common, PSMA-RGS presents an opportunity to prolong bPFS and TFS in a selection of patients.</p><p><strong>Patient summary: </strong>We updated outcomes from TRACE-I patients with recurrent prostate cancer. We found that PSMA-guided surgery led to PSA declines in most patients and delayed disease progression in some, but careful patient selection is essential.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857118","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: Lawlor A, Van Hemelrijck M, Moss C, et al. A Core Outcome Set for Localized Renal Cell Cancer (L-RCC-COS). Eur Urol Focus. In press. http://dx.doi.org/10.1016/j.euf.2026.06.017.","authors":"Jens Borgbjerg, Ole Graumann, David J Breen","doi":"10.1016/j.euf.2026.08.005","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.005","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148826515","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":"Prospective Multicenter Study on the Predictive Role of Node-RADS Score in Patients With Prostate Cancer Who Are Candidates for Radical Prostatectomy: Comparative Analysis with Validated Nomograms and PET/CT Scan.","authors":"Alessandro Sciarra, Paolo Casale, Giulio Bevilacqua, Greta Basile, Valerio Santarelli, Nicolò Maria Buffi, Massimo Lazzeri, Giovanni Lunghezzani, Sara Lucciola, Emanuele Messina, Ludovica Laschena, Ailin Dehghanpour, Giovanni Battista Di Pierro, Giorgio Franco, Francesco Del Giudice, Alessandro Gentilucci, Piervito Dipinto, Roberta Corvino, Stefano Salciccia, Fabio Massimo Magliocca, Valeria Panebianco","doi":"10.1016/j.euf.2026.08.002","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.002","url":null,"abstract":"<p><strong>Background and objective: </strong>This is the first prospective study analyzing the predictive value of preoperative Node-Reporting And Data System (RADS) determination at imaging for pelvic lymph node (PLN) involvement in cases of prostate cancer (PCa) considered for radical prostatectomy (RP) with extended pelvic lymph node dissection (ePLND). Node-RADS was compared with the validated predictive nomograms Briganti 2012, Gandaglia 2017, and Briganti 2019, and with prostate-specific membrane antigen - positron emission tomography/computed tomography (PSMA-PET/CT) total body scan.</p><p><strong>Methods: </strong>A total of 267 patients with a histological diagnosis of PCa undergoing RP with an ePLND were prospectively examined. Overall, n = 104 patients underwent PSMA-PET/CT. Node-RADS determination of PLNs was centrally performed using preoperative magnetic resonance imaging and compared with the validated nomograms and PSMA-PET/CT. Correspondence in terms of positivity and localization with final pathology was analyzed.</p><p><strong>Results: </strong>Node-RADS exceeded PSMA-PET/CT in overall accuracy (area under the curve [AUC] 0.637 vs 0.526), whereas the Briganti 2019 nomogram achieved the highest AUC (0.711). Combining Node-RADS and Briganti 2019 improved performance further (AUC 0.719). Node-RADS showed high specificity (0.993) and positive predictive value (0.506), useful to confirm nodal involvement, whereas Briganti 2019 demonstrated high sensitivity (0.952) and excellent NPV (0.960), useful to exclude nodal disease. PET/CT exhibited limited sensitivity and anatomical correspondence. At multivariate analysis, a high Node-RADS score (4-5) and pathological tumor (pT) stage (pT3) were the only variables associated with a higher risk of positive PLNs involvement at final pathology (adjusted odds ratio [aOR]: 12.60, 95% confidence interval [CI] 2.99-52.96, p < 0.001 for Node-RADS 4-5 and aOR 16.98, 95% CI 4.29-67.17, p < 0.001 for pT3b).</p><p><strong>Conclusions: </strong>Node-RADS, especially when combined with the Briganti 2019 nomogram, showed promising performance as a structured radiologic tool for preoperative nodal staging in this selected ePLND-eligible cohort.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790171","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":"Practical Clinical Consultation Guide to Radioligand Therapy in Prostate Cancer.","authors":"Jane McKenzie, Natalia Kovaleva, Louise Emmett, Michael Hofman, Shahneen Sandhu","doi":"10.1016/j.euf.2026.07.019","DOIUrl":"https://doi.org/10.1016/j.euf.2026.07.019","url":null,"abstract":"<p><p>Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) with 177-Lutetium-PSMA has significantly improved outcomes in advanced prostate cancer; however, optimising its clinical application requires a nuanced, individualised approach. This review outlines key principles for patient selection, therapeutic monitoring, and adaptive dosing strategies to maximise efficacy while limiting toxicity. Adaptive strategies, including dose escalation or fractionation informed by tumour volume, treatment pauces at exceptional response, and retreatment at relapse, offer opportunities to personalise and optimise therapy beyond the standard six-cycle regimen.Additionally, defining clinical, imaging, and molecular biomarkers for resistance and efficacy will improve patient selection and clinical outcomes. As novel radioisotopes and combination strategies emerge, optimising treatment approaches will be essential to realise the full potential of RLT in prostate cancer.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790148","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":"Water Vapor Thermal Therapy with Rezūm Versus Combination Pharmacotherapy for Male Lower Urinary Tract Symptoms due to Benign Prostatic Obstruction: 1-Yr Results From a Prospective, Multicenter, Pragmatic Randomized Controlled Trial (VAPEUR-RCT).","authors":"Sébastien Vincendeau, Evanguelos Xylinas, Marc Fourmarier, Ismael Galliot, Ambroise Salin, Souhil Lebdai, Jonathan Olivier, Paul Anderson, Charles Ballereau, Florian Laclergerie, Eric Barret, Vincent Misraï, Hakim Fassi-Fehri, Matthieu Durand, Richard Mallet, Quentin Franquet, Grégoire Robert, Lucie-Marie Scailteux, Caroline Beaudoint, Patrick O'Connor, Isabelle Searcy, Kathryn Goodrich, Jean-Nicolas Cornu, Romain Mathieu","doi":"10.1016/j.euf.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.001","url":null,"abstract":"<p><strong>Background and objective: </strong>The VAPEUR randomized controlled trial compared Rezūm water vapor thermal therapy (WVTT) with combination pharmacotherapy (CP; alpha-blockers plus 5-alpha-reductase inhibitors) in sexually active men with symptomatic benign prostatic obstruction (BPO).</p><p><strong>Methods: </strong>Overall, 151 men were randomized to WVTT (n = 75) or CP (n = 76). Primary endpoints changed from baseline to 1 yr in the International Prostate Symptom Score (IPSS) and Male Sexual Health Questionnaire (MSHQ) score. Secondary endpoints included surgical/medical treatment for recurring symptoms, ≥4 points IPSS worsening (ΔIPSS ≥4), and catheterization beyond 90 d post-procedure.</p><p><strong>Key findings and limitations: </strong>At 1 yr, IPSS improvement was greater with WVTT than CP (mean difference -4.6 points; 97.5% confidence interval [CI] -7.6 to -1.6; p < 0.001), with mean improvements of 10.8 ± 6.8 versus 6.2 ± 7.7 points, respectively. MSHQ scores remained stable with WVTT (+1.1 ± 16.9) and CP (-5.2 ± 16.4). Superiority in preserving sexual function was not demonstrated with multiple imputation. Quality‑of‑life (QoL) improvement was greater with WVTT (-2.7 ± 1.8 vs -1.8 ± 2.0; p = 0.01). WVTT resulted in lower rates of surgical retreatment (1.3% vs 9.2%), ΔIPSS ≥4, (2.7% vs 13%) and post-90 d catheterization (0% vs 1.3%), but higher pharmacological retreatment (12% vs 1.3%; combined: hazard ratio = 0.52, CI 0.25-1.1, p = 0.08). Treatment‑related adverse events (AEs) were more frequent with WVTT (40% vs 28%; serious AEs, 12% vs 1.3%), largely procedure‑related; at 1 yr, 93% were resolved in WVTT versus 60% (25/42) in CP.</p><p><strong>Conclusions and clinical implications: </strong>At 1 yr, WVTT provides superior symptom relief and greater QoL improvement versus CP, while preserving sexual function. These findings support WVTT as an effective alternative to CP.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790002","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}