European urology focus最新文献

{"title":"The Evolving Treatment Paradigm for Upper Tract Urothelial Carcinoma.","authors":"Saad O Atiq, Matthew D Galsky","doi":"10.1016/j.euf.2025.06.013","DOIUrl":"https://doi.org/10.1016/j.euf.2025.06.013","url":null,"abstract":"<p><p>Treatment decisions for patients with upper tract urothelial carcinoma (UTUC) require individualized assessments that weigh tumor characteristics, patient factors, and the evidence available. Adjuvant immune checkpoint blockade represents a significant advance in UTUC management, particularly for patients who are ineligible for cisplatin and those with residual disease after neoadjuvant therapy.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599788","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":"Renal Cell Carcinoma: What Are the Unmet Needs?","authors":"Nazli Dizman, Sumanta K Pal","doi":"10.1016/j.euf.2025.06.014","DOIUrl":"https://doi.org/10.1016/j.euf.2025.06.014","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590771","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":"KIM-1 as a Prognostic Marker in Renal Cell Carcinoma.","authors":"Clara Steiner, Marc Machaalani, Joseph V Bonventre, David F McDermott, Toni K Choueiri, Wenxin Xu","doi":"10.1016/j.euf.2025.06.012","DOIUrl":"https://doi.org/10.1016/j.euf.2025.06.012","url":null,"abstract":"<p><p>There is an unmet need for a noninvasive biomarker in renal cell carcinoma. KIM-1 has emerged as a compelling candidate according to retrospective evidence and post hoc analyses of prospective trials. Prospective studies are needed for validation and clinical implementation.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575144","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":"Considerations for Patient-reported Outcomes in the Management of Metastatic Renal Cell Carcinoma.","authors":"Andrew Schlager, Jasnoor Malhotra, Cristiane Decat Bergerot","doi":"10.1016/j.euf.2025.06.003","DOIUrl":"https://doi.org/10.1016/j.euf.2025.06.003","url":null,"abstract":"<p><p>Selection of the most appropriate patient-reported outcome measures is essential for accurate assessment of wellbeing in metastatic renal cell carcinoma (RCC). Existing tools provide useful information, but a more nuanced and comprehensive approach is necessary to capture the full scope of patient experiences. FKSI-23 is a new tool with distinct scoring options for localized and advanced RCC. Pending validation, its adoption could better align clinical evaluation with the realities of patients' lived experiences.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567351","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":"Robot-Assisted Retrograde Intrarenal Surgery: A Mini Review of the Literature on Robotic Surgery Platforms for Endoscopic Stone Surgery.","authors":"Hyung Joon Kim, Jose Carlo R Elises, Christine Joy Castillo, Nasser Aljameel, Fahad Alzahrani, Omar Sulaiman, Sung Yong Cho","doi":"10.1016/j.euf.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.euf.2025.06.011","url":null,"abstract":"<p><p>Retrograde intrarenal surgery (RIRS) has become a cornerstone in renal stone management, with robotic platforms recently entering clinical practice. This mini review examines the current landscape for robot-assisted RIRS, with a focus on the Roboflex Avicenna, ILY, Monarch, and Zamenix systems. Early clinical data demonstrate feasibility and safety, with potential ergonomic advantages, although robust evidence supporting superiority over conventional techniques remains limited. We describe the distinctive features of each platform, including console design, scope control mechanisms, and integration with endourological tools, and their regulatory status and clinical implementation. Potential benefits include better scope navigation, lower radiation exposure, and enhanced stone clearance, while challenges include high costs, limited accessibility, and the absence of tactile feedback. Future developments may integrate artificial intelligence, real-time surgical guidance, and miniaturized systems. As this technology matures, robotic RIRS could redefine management paradigms for complex stone cases and other upper tract pathology for which conventional approaches prove challenging. PATIENT SUMMARY: We reviewed studies on robot-assisted surgery for kidney stones. Early evidence shows that this approach has greater precision, lower radiation exposure, and less fatigue for the surgeon. It is expected that robotic surgery will result in better outcomes for these patients, but more studies are needed to confirm the early findings.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567352","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":"Extended Outcomes of Intravesical Valrubicin and Docetaxel as a Secondary Salvage Treatment for Recalcitrant High-risk Non-muscle-invasive Bladder Cancer.","authors":"Ian M McElree, Ryan L Steinberg, Helen Y Hougen, Sarah L Mott, Vignesh T Packiam, Michael A O'Donnell","doi":"10.1016/j.euf.2025.05.022","DOIUrl":"https://doi.org/10.1016/j.euf.2025.05.022","url":null,"abstract":"<p><strong>Background and objective: </strong>After multiple treatment failures, clinical practice guidelines recommend that patients with high-risk non-muscle-invasive bladder cancer (HR-NMIBC) undergo radical cystectomy (RC). However, since many patients will be either unfit or averse to radical surgery, additional bladder-sparing therapies are needed. Herein, we report the efficacy of sequential intravesical valrubicin and docetaxel (Val/Doce) as a salvage therapy for patients with recurrent HR-NMIBC.</p><p><strong>Methods: </strong>We retrospectively identified all patients with recurrent HR-NMIBC treated with Val/Doce between 2013 and 2024 at the University of Iowa. The primary outcome was high-grade recurrence-free survival (HG-RFS). Adverse events were reported using Common Terminology Criteria for Adverse Events version 5. Patients received weekly sequential intravesical instillations of 800 mg valrubicin and 37.5 mg docetaxel for 6 wk. Monthly maintenance of 2 yr was initiated if the patients were disease free at the first follow-up.</p><p><strong>Key findings and limitations: </strong>The final cohort included 139 patients with a median (interquartile range) follow-up of 25 (10-51) mo. Patients had a median of two prior treatments: 92 (66%) had prior bacillus Calmette-Guérin and 133 (96%) had prior a Gem/Doce treatment. Tumor pathology immediately prior to Val/Doce induction included 53 carcinoma in situ (CIS), 19 T1HG, six T1HG + CIS, 37 TaHG, 21 TaHG + CIS, and three TaLG + CIS cases. Additionally, 27 patients had urothelial carcinoma present in the prostatic urethra/ducts (PUC), and 38 had any history of PUC. The HG-RFS rates at 1, 2, and 3 yr were 58%, 45%, and 41%, respectively. The progression-free survival rates at 1, 3, and 5 yr were 95%, 84%, and 70%, respectively. The cancer-specific survival rate was 91% at 5 yr. Upon a univariate analysis, there were no factors associated with an increased risk of recurrence. However, PUC prior to Val/Doce induction was associated with an increased risk of progression (p = 0.02). Adverse events occurred in 73 patients (53%), including one grade 3 event.</p><p><strong>Conclusions and clinical implications: </strong>Val/Doce was safe and efficacious in patients with recurrent HR-NMIBC. The capacity to delay progression and avoid RC in a significant proportion of patients highlights its potential as a valuable treatment option in this challenging clinical context and warrants prospective evaluation.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511672","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":"Decision Regret About Testicular Prosthesis After Radical Orchiectomy: Real-life Data to Improve Preoperative Patient Counseling.","authors":"Luca Boeri, Federica Passarelli, Massimiliano Raffo, Ester Zino, Antonio Cimmino, Riccardo Ramadani, Gabriele Birolini, Edoardo Pozzi, Fausto Negri, Franco Gadda, Emanuele Montanari, Francesco Montorsi, Andrea Salonia","doi":"10.1016/j.euf.2025.05.015","DOIUrl":"10.1016/j.euf.2025.05.015","url":null,"abstract":"<p><strong>Background and objective: </strong>Patients undergoing orchiectomy for testicular cancer (TC) may have body image concerns, with a testicular prosthesis (TP) as a potential solution. Data on regret regarding synchronous TP placement are limited. We investigated postoperative patient-reported satisfaction and decision regret after unilateral orchiectomy for TC with or without synchronous TP placement.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 142 cN0M0 TC patients who underwent orchiectomy at two tertiary-referral academic centers between 2014 and 2023. A synchronous TP was proposed in all cases. In October 2024, patients completed a decision regret scale and questions on TP placement and satisfaction. Descriptive statistics and logistic regression were used for the analysis.</p><p><strong>Key findings and limitations: </strong>Sixty-one (43%) patients had synchronous TP placement. Patients with a TP more frequently reported that their decision was correct (p < 0.01), they had less regret (p = 0.01), and they would have repeated the same choice (p = 0.02). Patients without a TP more frequently reported that they were still missing the removed testicle and they felt ashamed about their body image (all p < 0.01). Partner's complaints about patient's body image were more common in men without a TP (p = 0.01). A multivariable analysis showed that TP placement (odds ratio 0.4, p = 0.03) was associated with less regret. This study may have selection biases, and larger, multicentric studies are needed.</p><p><strong>Conclusions and clinical implications: </strong>Patients with synchronous TP placement reported higher satisfaction, less negative body image, lower partner disappointment, and less regret than those without a TP. Preoperative counseling should emphasize long-term satisfaction with a TP.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144368738","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: Matthew J. Roberts, Giorgio Gandaglia, Daniela E. Oprea-Lager, et al. Pelvic Lymph Node Dissection in Prostate Cancer: Evidence and Implications. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2025.03.004.","authors":"André N Vis, Bernard H E Jansen-Stensland","doi":"10.1016/j.euf.2025.05.027","DOIUrl":"10.1016/j.euf.2025.05.027","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340058","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: Alexandra Masson-Lecomte, Guillaume Grisay, Julien Van Damme, et al. Challenges in Defining Clinical Complete Response to Systemic Therapy in Muscle-invasive Bladder Cancer: Insights from the EORTC STARBURST Project. Eur Urol Oncol. In press. https://doi.org/10.1016/j.euo.2025.03.005.","authors":"Marco Moschini, Giuseppe Rosiello, Giorgio Gandaglia, Alberto Briganti, Francesco Montorsi","doi":"10.1016/j.euf.2025.05.028","DOIUrl":"https://doi.org/10.1016/j.euf.2025.05.028","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301452","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":"Biological and Clinical Insight into the Prevention and Management of Metastatic Renal Cell Carcinoma with a Sarcomatoid Component.","authors":"Nicholas J Salgia, Yu Fujiwara, Bo Xu, Saby George, Jason B Muhitch, Eric C Kauffman","doi":"10.1016/j.euf.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.euf.2025.05.011","url":null,"abstract":"<p><p>Renal cell carcinoma with sarcomatoid dedifferentiation (sRCC) has high metastatic potential and poor prognosis. While metastatic sRCC is relatively resistant to conventional anticancer drugs, recent advances demonstrate that it is highly sensitive to immune checkpoint inhibitors (ICIs), with response rates as high as 60% to ICI-based combination therapies. Congruent with these discoveries, sRCC has been characterized by an increase in inflammatory programs potentially driving ICI sensitivity. In clinically localized sRCC, this unique immune sensitivity supports consideration for adjuvant ICI therapy to prevent post-nephrectomy metastasis, the risk of which increases with higher sarcomatoid percentage in the primary tumor. Together, these advances represent an exciting paradigm shift in the understanding and management of sRCC. PATIENT SUMMARY: While a type of kidney cancer called sRCC (renal cell carcinoma with sarcomatoid dedifferentiation) is very aggressive and resistant to typical anticancer therapies, recent evidence shows that it is highly sensitive to immunotherapy. Studies have confirmed that immune-related changes in sRCC tumors may explain this response.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293600","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}