European urology focus最新文献

{"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}

{"title":"Radioligand Therapy of the Prostate - the Sky Is the Limit?","authors":"Wolfgang P Fendler, Ken Herrmann","doi":"10.1016/j.euf.2026.08.003","DOIUrl":"https://doi.org/10.1016/j.euf.2026.08.003","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790146","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: Little M, Wolstenholme J, Landeiro F, Marian IR, Williams R, Francisco Lopez J, et al. Cost Effectiveness of Local Anaesthetic Transperineal Versus Transrectal Biopsy: Results from the TRANSLATE Study. Eur Urol Focus 2026;12:227-36.","authors":"Flavio Lobo Heldwein, Gabriela Garcia Korczaguin, Marcelo Langer Wroclawski","doi":"10.1016/j.euf.2026.07.018","DOIUrl":"https://doi.org/10.1016/j.euf.2026.07.018","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790182","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":"PSMA Radioligand Therapy: Success and Limitations to Date.","authors":"Oliver Sartor","doi":"10.1016/j.euf.2026.07.010","DOIUrl":"https://doi.org/10.1016/j.euf.2026.07.010","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148790215","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":"Prognostic Value of Perioperative Circulating Tumor DNA in Pure Urothelial Carcinoma and Histological Subtypes of Bladder Cancer.","authors":"Pierre-Etienne Gabriel, Alec Zhu, Christopher Karim, Ahmed Eraky, Raghav Gupta, Reuben Ben-David, Peter Wiklund, Reza Mehrazin, John P Sfakianos","doi":"10.1016/j.euf.2026.06.026","DOIUrl":"10.1016/j.euf.2026.06.026","url":null,"abstract":"<p><strong>Background and objective: </strong>Pure urothelial carcinoma (UC) and histological subtypes (HS) in bladder cancer (BC) are associated with distinct pathological features and oncologic outcomes across disease stages. Circulating tumor DNA (ctDNA) is a promising perioperative biomarker, but its prognostic performance across histologic subtypes remains unclear. We evaluated the prognostic value of perioperative tumor-informed ctDNA in patients with pure UC and HS.</p><p><strong>Methods: </strong>We analyzed a database of consecutive patients with BC who underwent radical cystectomy with available preoperative or postoperative ctDNA between 2021 and 2025. Patients were stratified into four groups according to histology status and ctDNA detectability at both preoperative and postoperative time points. Disease-free survival (DFS) was estimated using the Kaplan-Meier method and compared with log-rank tests. Associations between groups and DFS were evaluated using uni- and multivariable Cox regression analyses.</p><p><strong>Key findings and limitations: </strong>Among 138 patients with preoperative ctDNA, negative ctDNA status was associated with significantly higher 24-mo DFS compared with positive ctDNA in both pure UC (89% vs 49%, p < 0.001) and HS (79% vs 43%, p = 0.012). Multivariable Cox regression confirmed positive preoperative ctDNA as an independent predictor of recurrence or death in pure UC (hazard ratio [HR] = 4.07, 95% confidence interval [CI] = 1.29-12.81, p = 0.020) and HS groups (HR = 3.99, 95% CI = 1.24-12.82, p = 0.023). Similarly, among 144 patients with postoperative ctDNA, negative ctDNA status predicted higher 24-mo DFS in pure UC (81% vs 30%, p < 0.001) and HS (66% vs 29%, p < 0.001), with positive postoperative ctDNA independently associated with disease recurrence or death in pure UC (HR = 4.38, 95% CI = 1.66-11.52, p < 0.01) and HS groups (HR = 4.52, 95% CI = 1.86-11.03, p < 0.001). Limitations include the retrospective design and relatively short follow-up.</p><p><strong>Conclusions and clinical implications: </strong>Perioperative ctDNA is a robust biomarker with consistent prognostic value and can refine perioperative risk stratification in patients with BC with pure UC or HS.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720838","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":"Accuracy, Completeness, and Clarity of an AI-Based Chatbot for the EAU Neuro-Urology Guidelines.","authors":"Sabrina De Cillis, Riccardo Lombardo, Daniele Amparore, Matteo Romagnoli, Marta Santioni, Manfredi Bruno Sequi, Federico Piramide, Alberto Piana, Alberto Quara', Matteo Manfredi, Eleonora Rosato, Mauro Ragonese, Valerio Santarelli, Pietro Spatafora, Giacomo Gallo, Vincenzo Pagliarulo, Giorgia Tema, Antonio Franco, Antonio Luigi Pastore, Bernardo Rocco, Mauro Gacci, Cristian Fiori, Enrico Finazzi, Alessandro Sciarra, Andrea Tubaro, Francesco Porpiglia, Cosimo De Nunzio","doi":"10.1016/j.euf.2026.06.025","DOIUrl":"https://doi.org/10.1016/j.euf.2026.06.025","url":null,"abstract":"<p><p>This study aimed to externally validate the performance of the European Association of Urology (EAU) Guidelines Bot in neuro-urology by assessing the accuracy, completeness, and clarity of chatbot-generated answers to guideline-based questions and to compare its performance with that of a general-purpose large language model (ChatGPT 5.5). A cross-sectional validation study was conducted using 47 questions derived from the EAU Neuro-Urology Guidelines. Each question was linked to a specific recommendation and classified by recommendation strength (strong vs weak). Questions were independently submitted to both the EAU Guidelines Bot and ChatGPT 5.5 without additional prompting. Two expert urologists independently evaluated each response for accuracy, completeness, and clarity using a five-point Likert scale; discrepancies were resolved by a third reviewer. Overall, 45 questions (95.7%) were linked to strong recommendations and two (4.3%) to weak recommendations. The EAU Guidelines Bot and ChatGPT 5.5 achieved identical mean accuracy scores (4.96 ± 0.20), with all responses rated as highly accurate (Likert 4-5). ChatGPT 5.5 indicated significantly higher completeness scores than did the EAU Guidelines Bot (4.74 ± 0.44 vs 4.57 ± 0.54; p = 0.011), whereas clarity scores were not significantly different (4.83 ± 0.38 vs 4.77 ± 0.43; p = 0.083). High-quality completeness was observed in 46/47 EAU Guidelines Bot responses (97.9%) and 47/47 ChatGPT responses (100%). Score discrepancies between systems were identified in ten of 47 questions (21.3%) and were limited to completeness and clarity domains. Performance remained uniformly high across recommendation grades, with no meaningful differences observed. The EAU Guidelines Bot showed excellent accuracy, completeness, and clarity when applied to neuro-urology guideline-based questions. Its performance was comparable to that of ChatGPT 5.5, with both systems providing highly accurate guideline-concordant responses. Although ChatGPT 5.5 generated more comprehensive answers, the EAU Guidelines Bot maintained closer adherence to the original guideline recommendations. Although not a substitute for clinical judgment, the tool appears to be a reliable adjunct for rapid access to evidence-based neuro-urological guidance.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148683781","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":"Lutetium-177-PSMA-617 in Oligo-metastatic Hormone-sensitive Prostate Cancer (BULLSEYE): A Trial Update.","authors":"Bastiaan M Privé, Daniela E Oprea-Lager, Constantijn H J Muselaers, Bart Timmermans, Inge M van Oort, Niven Mehra, J P Michiel Sedelaar, Alexis Vrachimis, Walter Noordzij, James Nagarajah","doi":"10.1016/j.euf.2026.07.013","DOIUrl":"https://doi.org/10.1016/j.euf.2026.07.013","url":null,"abstract":"<p><p>The BULLSEYE study suggests a role for [¹⁷⁷Lu]Lu-PSMA-617 in the management of oligometastatic hormone-sensitive prostate cancer.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":""},"PeriodicalIF":6.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677558","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}