European urology focus最新文献

{"title":"Role of Microbiome Testing in Everyday Clinical Urology.","authors":"Glenn T Werneburg","doi":"10.1016/j.euf.2024.11.002","DOIUrl":"10.1016/j.euf.2024.11.002","url":null,"abstract":"<p><p>Standard laboratory cultures and biomarkers for urologic conditions have limitations that have led to great interest in microbiome testing in urology. Microbiome testing may play a role in clinical urology in the future in areas such as diagnosis of infections, biomarkers for diagnosis and prognosis of functional and oncological conditions, and targeted microbial modulation to augment existing treatment modalities and reduce disease risk.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":"886-888"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681334","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":"Enhancing the Immunogenicity of Nivolumab plus Ipilimumab with Live Bacterial Supplementation in Metastatic Renal Cell Carcinoma.","authors":"Kevin K Zarrabi, Ulka Vaishampayan, Pedro C Barata","doi":"10.1016/j.euf.2025.01.003","DOIUrl":"10.1016/j.euf.2025.01.003","url":null,"abstract":"<p><p>Dysbiosis may hinder effective tumor immunity and reduce the efficacy of therapies such as immune checkpoint blockade (ICB) in renal cell carcinoma (RCC). CBM588, a product containing live Clostridium butyricum, has shown promise in enhancing ICB effectiveness in metastatic RCC in terms of response rates and progression-free survival. Further research to confirm these findings should take factors such as diet and microbiome composition into account and include predictive biomarkers for patient selection.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":"879-881"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143002885","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":"A Video-illustrated Overview of Reconstructive Surgical Techniques Following Penile Cancer Treatment.","authors":"Kaat Vandermaesen, Wai Gin Lee, Laura Elst, Marije Hoornweg, Oscar R Brouwer, Maarten Albersen","doi":"10.1016/j.euf.2024.05.021","DOIUrl":"10.1016/j.euf.2024.05.021","url":null,"abstract":"<p><p>Surgery is the cornerstone of treatment for penile squamous cell carcinoma. Following surgical excision, reconstructive surgery is beneficial to restore aesthetics, functionality, and overall quality of life of these patients. In this mini-review, we discuss the use of skin grafts, perineal urethrostomy, phalloplasty, and vascularised flaps as reconstructive options following penile cancer treatment. Illustrated by videos, we highlight the surgical approach, indications, complications, and outcomes of these reconstructive strategies. PATIENT SUMMARY: Reconstructive surgery is important to restore appearance, urinary function, and sexual function in patients who have been treated for penile cancer. We discuss the benefits and potential complications of various surgical reconstructive options, which are illustrated with videos.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":"935-937"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327371","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":"Diagnostic Test Accuracy of Urinary DNA Methylation-based Biomarkers for the Detection of Primary and Recurrent Bladder Cancer: A Systematic Review and Meta-analysis.","authors":"Mariana Silva-Ferreira, João A Carvalho, Sofia Salta, Teresa S Henriques, Pedro Pereira Rodrigues, Sara Monteiro-Reis, Rui Henrique, Carmen Jerónimo","doi":"10.1016/j.euf.2024.05.024","DOIUrl":"10.1016/j.euf.2024.05.024","url":null,"abstract":"<p><strong>Background and objective: </strong>Diagnosis of primary and relapsed bladder carcinomas is accomplished by urethrocystoscopy, an invasive procedure, combined with urinary cytology, with limited sensitivity, resulting in a substantial burden. Thus, noninvasive biomarkers have been investigated, among which DNA methylation has shown promise. This systematic review and meta-analysis sought to assess the diagnostic accuracy of DNA methylation biomarkers reported in the literature for bladder cancer detection, pinpointing the most informative one.</p><p><strong>Methods: </strong>The search for this systematic review and meta-analysis was conducted on PubMed, Scopus, and Cochrane Library for relevant studies published until December 31, 2022. A meta-analysis was performed using a random-effect model, to compute the pooled sensitivity and specificity of the markers. PROSPERO's registration ID for the study is CRD42023397703.</p><p><strong>Key findings and limitations: </strong>Out of the 2297 studies retrieved, 68 were included in the final analysis, despite considerable heterogeneity. These involved 12 696 participants, of whom 5557 were diagnosed with bladder cancer. Using diagnostic odds ratio (DOR) as a comparative measure, the five most promising markers (pooled sensitivity, specificity, and DOR) were SALL3 (61%, 97%, and 55.67, respectively), PENK (77%, 93%, and 47.90, respectively), ZNF154 (87%, 90%, and 45.07, respectively), VIM (82%, 90%, and 44.81, respectively), and POU4F2 (81%, 89%, and 34.89, respectively). Urinary cytology identified bladder cancer with 55% sensitivity, 92% specificity, and 14.37 DOR.</p><p><strong>Conclusions and clinical implications: </strong>DNA methylation biomarkers disclose high accuracy for bladder cancer detection in urine. Nonetheless, validation studies in different clinical settings are scarce, hampering clinical use. The identified biomarkers should be prioritized in future validation studies.</p><p><strong>Patient summary: </strong>In this meta-analysis, we include previously published studies that used urine samples of bladder cancer patients' from all around the globe. We were able to compare the diagnostic accuracy of noninvasive markers across different populations. We were able to conclude on the most promising DNA methylation markers to detect bladder cancer using urine.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":"922-934"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426652","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":"Advancements in the front-line treatment of metastatic urothelial carcinoma.","authors":"Sarah M H Einerhand, Michiel S van der Heijden","doi":"10.1016/j.euf.2024.06.003","DOIUrl":"10.1016/j.euf.2024.06.003","url":null,"abstract":"<p><p>Both the CheckMate-901 (gemcitabine-cisplatin plus nivolumab) trial and the EV-302 (enfortumab-vedotin plus pembrolizumab; EV+P) trial have shown a significant improvement in OS over standard (cis)platinum-based chemotherapy. The effect size, as well as the broader eligibility criteria for EV+P position this regimen as a compelling preferred candidate for the new standard of care in front-line mUC treatment.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":"972-974"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105849","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: Riccardo Mastroianni, Gabriele Tuderti, Mariaconsiglia Ferriero, et al. Robot-assisted Radical Cystectomy with Totally Intracorporeal Urinary Diversion Versus Open Radical Cystectomy: 3-Year Outcomes from a Randomised Controlled Trial. Eur Urol 2024;85:422-30.","authors":"Wei He, Shuxiong Zeng, Chuanliang Xu","doi":"10.1016/j.euf.2024.04.010","DOIUrl":"10.1016/j.euf.2024.04.010","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":"1062-1063"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247619","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":"Data Availability Statements and Data Sharing in Urology: A False Promise?","authors":"Maria Giovanna Asmundo, Emil Durukan, Giorgio Ivan Russo, Christian Fuglesang S Jensen, Peter Busch Østergren, Sebastiano Cimino, Mikkel Fode","doi":"10.1016/j.euf.2024.05.019","DOIUrl":"10.1016/j.euf.2024.05.019","url":null,"abstract":"<p><strong>Background and objective: </strong>It is considered standard for authors of scientific papers to provide access to their raw data. The purpose of this study was to investigate data availability statements (DAS) and the actual availability of data in urology.</p><p><strong>Methods: </strong>The DAS policies of the top ten urology journals were retrieved. Then 190 selected papers were classified according to their DAS status. Finally, we contacted the corresponding authors of papers that stated that data were available on request to enquire about this possibility.</p><p><strong>Key findings and limitations: </strong>All journals either required or highly recommended a DAS. Among the selected articles, 52% (99/190) included a DAS stating data availability, most often on reasonable request to the corresponding author. A formal DAS was lacking in 29.5% (56/190) of the articles, with an additional 18.3% (35/190) citing various reasons for data unavailability. On contact, 23.4% (15/64) of corresponding authors indicated a willingness to share their data. Overall, data were unavailable in 73.7% (140/190) of cases. There was no difference between papers dealing with malignant and benign diseases.</p><p><strong>Conclusions and clinical implications: </strong>There is a gap between the intention to share data and actual practice in major urological journals. As data sharing plays a critical role in safeguarding the reliability of published results and in the potential for reanalysis and merging of datasets, there is a clear need for improvement. Easier access to data repositories and stronger enforcement of existing journal policies are essential.</p><p><strong>Patient summary: </strong>To ensure the reliability of data and allow further analyses, major urology journals require authors to make their data available to other researchers when possible. However, in practice we found that data were only accessible for about a quarter of published scientific papers.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":"999-1002"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261929","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 Wei He, Shuxiong Zeng, and Chuanliang Xu's Letter to the Editor re: Riccardo Mastroianni, Gabriele Tuderti, Mariaconsiglia Ferriero, et al. Robot-assisted Radical Cystectomy with Totally Intracorporeal Urinary Diversion Versus Open Radical Cystectomy: 3-Year Outcomes from a Randomised Controlled Trial. Eur Urol 2024;85:422-30.","authors":"Riccardo Mastroianni, Giuseppe Chiacchio, Giuseppe Simone","doi":"10.1016/j.euf.2024.06.002","DOIUrl":"10.1016/j.euf.2024.06.002","url":null,"abstract":"","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":"1068-1069"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330693","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":"Machine Learning and External Validation of the IDENTIFY Risk Calculator for Patients with Haematuria Referred to Secondary Care for Suspected Urinary Tract Cancer.","authors":"Sinan Khadhouri, Artsiom Hramyka, Kevin Gallagher, Alexander Light, Simona Ippoliti, Marie Edison, Cameron Alexander, Meghana Kulkarni, Eleanor Zimmermann, Arjun Nathan, Luca Orecchia, Ravi Banthia, Pietro Piazza, David Mak, Nikolaos Pyrgidis, Prabhat Narayan, Pablo Abad Lopez, Faisal Nawaz, Trung-Thanh Tran, Francesco Claps, Donnacha Hogan, Juan Gomez Rivas, Santiago Alonso, Ijeoma Chibuzo, Beatriz Gutierrez Hidalgo, Jessica Whitburn, Jeremy Teoh, Gautier Marcq, Alexandra Szostek, Jasper Bondad, Petros Sountoulides, Tom Kelsey, Veeru Kasivisvanathan","doi":"10.1016/j.euf.2024.06.004","DOIUrl":"10.1016/j.euf.2024.06.004","url":null,"abstract":"<p><strong>Background: </strong>The IDENTIFY study developed a model to predict urinary tract cancer using patient characteristics from a large multicentre, international cohort of patients referred with haematuria. In addition to calculating an individual's cancer risk, it proposes thresholds to stratify them into very-low-risk (<1%), low-risk (1-<5%), intermediate-risk (5-<20%), and high-risk (≥20%) groups.</p><p><strong>Objective: </strong>To externally validate the IDENTIFY haematuria risk calculator and compare traditional regression with machine learning algorithms.</p><p><strong>Design, setting, and participants: </strong>Prospective data were collected on patients referred to secondary care with new haematuria. Data were collected for patient variables included in the IDENTIFY risk calculator, cancer outcome, and TNM staging. Machine learning methods were used to evaluate whether better models than those developed with traditional regression methods existed.</p><p><strong>Outcome measurements and statistical analysis: </strong>The area under the receiver operating characteristic curve (AUC) for the detection of urinary tract cancer, calibration coefficient, calibration in the large (CITL), and Brier score were determined.</p><p><strong>Results and limitations: </strong>There were 3582 patients in the validation cohort. The development and validation cohorts were well matched. The AUC of the IDENTIFY risk calculator on the validation cohort was 0.78. This improved to 0.80 on a subanalysis of urothelial cancer prevalent countries alone, with a calibration slope of 1.04, CITL of 0.24, and Brier score of 0.14. The best machine learning model was Random Forest, which achieved an AUC of 0.76 on the validation cohort. There were no cancers stratified to the very-low-risk group in the validation cohort. Most cancers were stratified to the intermediate- and high-risk groups, with more aggressive cancers in higher-risk groups.</p><p><strong>Conclusions: </strong>The IDENTIFY risk calculator performed well at predicting cancer in patients referred with haematuria on external validation. This tool can be used by urologists to better counsel patients on their cancer risks, to prioritise diagnostic resources on appropriate patients, and to avoid unnecessary invasive procedures in those with a very low risk of cancer.</p><p><strong>Patient summary: </strong>We previously developed a calculator that predicts patients' risk of cancer when they have blood in their urine, based on their personal characteristics. We have validated this risk calculator, by testing it on a separate group of patients to ensure that it works as expected. Most patients found to have cancer tended to be in the higher-risk groups and had more aggressive types of cancer with a higher risk. This tool can be used by clinicians to fast-track high-risk patients based on the calculator and investigate them more thoroughly.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":"1034-1042"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436791","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":"Readability Assessment of Patient Education Materials on Uro-oncological Diseases Using Automated Measures.","authors":"Severin Rodler, Serena Maruccia, Andre Abreu, Declan Murphy, David Canes, Stacy Loeb, Rena D Malik, Aditya Bagrodia, Giovanni E Cacciamani","doi":"10.1016/j.euf.2024.06.012","DOIUrl":"10.1016/j.euf.2024.06.012","url":null,"abstract":"<p><strong>Background and objective: </strong>Readability of patient education materials is of utmost importance to ensure understandability and dissemination of health care information in uro-oncology. We aimed to investigate the readability of the official patient education materials of the European Association of Urology (EAU) and American Urology Association (AUA).</p><p><strong>Methods: </strong>Patient education materials for prostate, bladder, kidney, testicular, penile, and urethral cancers were retrieved from the respective organizations. Readability was assessed via the WebFX online tool for Flesch Kincaid Reading Ease Score (FRES) and for reading grade levels by Flesch Kincaid Grade Level (FKGL), Gunning Fog Score (GFS), Smog Index (SI), Coleman Liau Index (CLI), and Automated Readability Index (ARI). Layperson readability was defined as a FRES of ≥70 and with the other readability indexes <7 according to European Union recommendations. This study assessed only objective readability and no other metrics such as understandability.</p><p><strong>Key findings and limitations: </strong>Most patient education materials failed to meet the recommended threshold for laypersons. The mean readability for EAU patient education material was as follows: FRES 50.9 (standard error [SE]: 3.0), and FKGL, GFS, SI, CLI, and ARI all with scores ≥7. The mean readability for AUA patient material was as follows: FRES 64.0 (SE: 1.4), with all of FKGL, GFS, SI, and ARI scoring ≥7 readability. Only 13 out of 70 (18.6%) patient education materials' paragraphs met the readability requirements. The mean readability for bladder cancer patient education materials was the lowest, with a FRES of 36.7 (SE: 4.1).</p><p><strong>Conclusions and clinical implications: </strong>Patient education materials from leading urological associations reveal readability levels beyond the recommended thresholds for laypersons and may not be understood easily by patients. There is a future need for more patient-friendly reading materials.</p><p><strong>Patient summary: </strong>This study checked whether health information about different cancers was easy to read. Most of it was too hard for patients to understand.</p>","PeriodicalId":12160,"journal":{"name":"European urology focus","volume":" ","pages":"1055-1061"},"PeriodicalIF":4.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758071","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}