European urology最新文献

{"title":"Re: Brian Shuch, Allan J. Pantuck, Jean-Christophe Bernhard, et al. [89Zr]Zr-girentuximab for PET-CT Imaging of Clear-cell Renal Cell Carcinoma: A Prospective, Open-label, Multicentre, Phase 3 Trial. Lancet Oncol 2024;25:1277–87","authors":"Zhuo Tony Su, Mohammad E. Allaf, Nirmish Singla","doi":"10.1016/j.eururo.2025.01.025","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.025","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"65 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143806004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Ventral Versus Dorsal Onlay Buccal Mucosal Graft Urethroplasty for Non-traumatic Proximal Bulbar Urethral Strictures in Sexually Active Men: Erectile and Urinary Functions","authors":"Navid Roessler, Jakob Klemm, Wesley Verla, Malte W. Vetterlein","doi":"10.1016/j.eururo.2025.03.013","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.03.013","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"89 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143805955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-in-human Study of a Dual-modality Prostate-specific Membrane Antigen–targeted Probe for Preoperative Positron Emission Tomography/Computed Tomography Imaging and Intraoperative Fluorescence Imaging in Prostate Cancer","authors":"Silu Chen, Hongchuang Xu, Xueqi Chen, Qi Shen, Xu Chen, Meng Zhang, Zhihua Li, Zhongyuan Zhang, Han Hao, Wei Yu, Yan Fan, Liqun Zhou, Ning Zhang, Jianhua Zhang, Xing Yang, Cheng Shen, Xuesong Li","doi":"10.1016/j.eururo.2025.03.010","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.03.010","url":null,"abstract":"<h3>Background and objective</h3>Accurately distinguishing between cancerous and noncancerous tissues during robot-assisted radical prostatectomy (RARP) is a challenge that can increase the risk of residual disease. This study aimed to evaluate the safety, optimal dose and accuracy of a dual-modality prostate-specific membrane antigen (PSMA)-targeted probe (⁶⁸Ga-P3) for preoperative positron emission tomography (PET)/computed tomography (CT) imaging and intraoperative fluorescence imaging in prostate cancer.<h3>Methods and surgical procedure</h3>Each participant received an intravenous chemical dose of ⁶⁸Ga-P3 (10, 20, and 40 μg/kg), with radioactivity of 3.7 MBq/kg. PET/CT imaging was conducted 30, 60, and 120 min after injection to evaluate its biodistribution and dosimetry. RARP was performed at 24 ± 6 h after injection, in the sensitive mode of Firefly fluorescence imaging.<h3>Key findings and limitations</h3>Between May 2024 and July 2024, a total of 16 patients were included; ⁶⁸Ga-P3 was well tolerated without any adverse events related to ⁶⁸Ga-P3 administration or fluorescence imaging. At 2 h after administration, the median tumor maximum standardized uptake value was 5.3 (4.1–8.1). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ⁶⁸Ga-P3 PET/CT for tumor localization were 79.1%, 90.4%, 81.5%, and 89.0%, respectively. The overall NPV, PPV, and accuracy of intraoperative fluorescence imaging were 100%, 43.8%, and 90.9%, respectively. Of overall false-positive sites, 88.9% (8/9) were confirmed as tumor adjacent to the surgical margin. A dose of 40 μg/kg resulted in the highest accuracy of 92.3%.<h3>Conclusions and clinical implications</h3>In PSMA-targeted PET imaging and fluorescence-guided surgery, ⁶⁸Ga-P3 is safe and feasible for use, offering a novel tool for the surgical management of prostate cancer.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"25 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143806001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Association of Declining Prostate-specific Antigen Levels with Clinical Outcomes in Patients with Metastatic Castration-resistant Prostate Cancer Receiving [177Lu]Lu-PSMA-617 in the Phase 3 VISION Trial” [Eur. Urol. 86 (2024) 552–562]","authors":"Andrew J. Armstrong, Oliver Sartor, Johann de Bono, Kim Chi, Karim Fizazi, Bernd J. Krause, Ken Herrmann, Kambiz Rahbar, Scott T. Tagawa, Fred Saad, Tomasz M. Beer, Jiwen Wu, Osvaldo Mirante, Michael J. Morris","doi":"10.1016/j.eururo.2025.03.008","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.03.008","url":null,"abstract":"The authors regret a minor data error in the reporting of best radiographic responses in Supplementary Table 5 in the Supplementary Material. The percentage of patients with an evaluable response who had progressive disease (PD) in the 'Increase' subgroup for best overall PSA decline from baseline in the ¹⁷⁷Lu-PSMA-617 arm should be 31% not 40%. The number of patients with PD (<em>n</em> = 22) and the denominator (<em>n</em> = 71) remain correct. The data in the Table should therefore read as ‘22 (31)’ not ‘22 (40)’. The authors also note that the rows in this Table are slightly misaligned vertically but are presented in the correct order.<span><figure><span><img alt=\"\" height=\"479\" src=\"https://ars.els-cdn.com/content/image/1-s2.0-S0302283825001794-fx1.jpg\"/><ol><li><span><span>Download: <span>Download high-res image (521KB)</span></span></span></li><li><span><span>Download: <span>Download full-size image</span></span></span></li></ol></span></figure></span>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"217 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143798181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pelvic Lymph Node Dissection in Prostate Cancer: Evidence and Implications","authors":"Matthew J. Roberts, Giorgio Gandaglia, Daniela E. Oprea-Lager, Johan Stranne, Philip Cornford, Derya Tilki","doi":"10.1016/j.eururo.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.03.004","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>Why perform pelvic lymph node dissection?</h2>Pelvic lymph node dissection (PLND) performed during radical prostatectomy (RP) has been recommended for many years by international guidelines, including previous editions of the EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines, for staging purposes and a potential oncological benefit. An extended PLND (ePLND) template detects more metastases than a standard template and so is recommended by the guidelines when PLND is deemed necessary. ePLND staging information can ideally assist with postoperative</section></section><section><section><h2>Patient selection for PLND</h2>Validated nomograms based on preoperative information have been used to individualise patient selection for ePLND for more than 20 yr to overcome the limitations of conventional imaging (CT, magnetic resonance imaging [MRI]) in terms of sensitivity. Different nomogram cutoffs have been proposed to maximise capture of patients who are likely to have pN1 disease while trying to avoid routine PLND in all patients. Historically, nomogram cutoff ranges of 5–7% were proposed and could result in</section></section><section><section><h2>The 2024 EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines Panel position</h2>The prior “strong” recommendation to perform ePLND because of its ability to accurately stage disease was revisited following review of the available evidence and consideration of risk/benefit ratio. The change in recommendation in 2024 was driven in part by the decision to recommend PSMA PET for staging assessment of patients before treatment. PSMA PET/CT is highly specific but with a negative predictive value of approximately 80% [9], [10], where most of missed metastases are low volume</section></section>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"1 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Systematic Review and Meta-analysis of the Role of Prostate-specific Membrane Antigen Positron Emission Tomography for Prostate Cancer Diagnosis and Primary Staging before Definitive Treatment","authors":"Elio Mazzone, Donato Cannoletta, Leonardo Quarta, David C. Chen, Alice Thomson, Francesco Barletta, Armando Stabile, Daniel Moon, Renu Eapen, Nathan Lawrentschuk, Francesco Montorsi, Shankar Siva, Michael S. Hofman, Arturo Chiti, Declan G. Murphy, Alberto Briganti, Marlon L. Perera","doi":"10.1016/j.eururo.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.03.003","url":null,"abstract":"&lt;h3&gt;Background and objective&lt;/h3&gt;Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) in the diagnosis and primary staging of patients with prostate cancer (PCa) has an established role, but recent summative evidence on its actual diagnostic and staging value is still missing. We aimed to collect and analyze published studies reporting the accuracy of PSMA PET for the diagnosis of clinically significant prostate cancer (csPCa) and detection of distant metastases at primary staging before definitive treatment.&lt;h3&gt;Methods&lt;/h3&gt;We performed a systematic review of the literature, by searching the PubMed/MEDLINE, Cochrane library’s CENTRAL, EMBASE, and Scopus databases, from inception to April 2024. Two coprimary outcomes were assessed: first, to evaluate the sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of PSMA PET in detecting intraprostatic csPCa on a per-patient level, and second, to assess the positivity rates of metastatic disease in the primary staging, prior to definitive therapy. As a secondary outcome, the diagnostic accuracy of PET PSMA for the detection of lymph nodal invasion (LNI) was tested in a per-patient–level analysis of studies where pelvic lymph node dissection (PLND) was available as the reference standard. Positivity and detection rates were pooled using random-effect models. Preplanned subgroup analyses tested the diagnostic accuracy of PET PSMA across different study cohorts. Variation in PPV and NPV over csPCa and LNI prevalence was evaluated.&lt;h3&gt;Key findings and limitations&lt;/h3&gt;In total, 12 and 99 studies, with a total of 1533 and 18 649 participants, respectively, were included in the quantitative synthesis for intraprostatic diagnosis and staging. For intraprostatic disease, the sensitivity, specificity, PPV, and NPV of PSMA PET for csPCa were 82% (95% confidence interval [CI] 73–90%), 67% (95% CI 46–85%), 77% (95% CI 63–88%), and 73% (95% CI 56–87%), respectively. At a bivariate analysis, the diagnostic accuracy of PSMA PET estimated through a summary receiver operating characteristic curve–derived area under the curve was 84%, increasing up to 88% when combined with magnetic resonance imaging (MRI). On staging level, PSMA PET results were positive outside the prostate in 23% of the patients, with substantial variation in positivity rates between high-risk (31%) and intermediate-risk (12%) subcohorts. When using PLND as the reference standard (51 studies, 7713 patients), the sensitivity, specificity, PPV, and NPV of PSMA PET were, respectively, 54%, 94%, 77%, and 86%. With higher csPCa and LNI prevalence, a similar increase in PPV and a decrease in NPV were observed.&lt;h3&gt;Conclusions and clinical implications&lt;/h3&gt;The current updated systematic review and meta-analysis provides updated evidence on the diagnostic and staging accuracy of PSMA PET in PCa. We reported good accuracy of PSMA PET to discriminate csPCa, particularly when added to MRI, but NPV alone is insuf","PeriodicalId":12223,"journal":{"name":"European urology","volume":"183 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Andreas Josefsson, Marianne Månsson, Kimia Kohestani, et al. Performance of 4Kscore as a Reflex Test to Prostate-specific Antigen in the GÖTEBORG-2 Prostate Cancer Screening Trial. Eur Urol 2024;86:223–9","authors":"Francesco Montorsi, Giorgio Gandaglia, Francesco Barletta, Alberto Briganti","doi":"10.1016/j.eururo.2025.01.029","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.01.029","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"183 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143713475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards Epigenetic-based Subtyping of Bladder Cancer: DNA Methylation Predicts Molecular Subtypes of Non–muscle-invasive Bladder Cancer","authors":"Minghao Yu, Anshita Goel, Benjamin Tura, Celina M. Whalley, Kar Keung Cheng, Maurice P. Zeegers, Nicholas D. James, Lars Dyrskjøt, Douglas G. Ward, Richard T. Bryan, Roland Arnold","doi":"10.1016/j.eururo.2025.02.011","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.02.011","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"40 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Precise Scientific Communication: Nonrandomized Trials Should Not Be Described as Phase 3, and Registrational-intent Trials Should Not Be Described as Phase 2","authors":"Brant A. Inman, Andrew J. Vickers","doi":"10.1016/j.eururo.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.03.001","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"22 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143666380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2025 Update on Male Infertility","authors":"Suks Minhas, Luca Boeri, Paolo Capogrosso, Andrea Cocci, Giovanni Corona, Marij Dinkelman-Smit, Marco Falcone, Christian Fuglesang Jensen, Murat Gül, Arif Kalkanli, Ates Kadioğlu, Juan I. Martinez-Salamanca, L. Afonso Morgado, Giorgio I. Russo, Ege Can Serefoğlu, Paolo Verze, Andrea Salonia","doi":"10.1016/j.eururo.2025.02.026","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.02.026","url":null,"abstract":"<h3>Background and objective</h3>To present a summary of the updated 2025 European Association of Urology (EAU) Guidelines on Sexual and Reproductive Health (SRH) on male infertility, providing practical recommendations on the clinical work-up with a focus on diagnosis, treatment and follow-up.<h3>Methods</h3>For the 2025 SRH guidelines, new and relevant evidence was identified, collated, and appraised via a structured assessment of the literature. Databases searched included Medline, EMBASE, and the Cochrane Libraries. Recommendations within the guidelines were developed by the panel to prioritise clinically important care decisions. The strength of each recommendation was determined according to a balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including the certainty of estimates), and the nature and variability of patient values and preferences.<h3>Key findings and limitations</h3>Key recommendations emphasise the importance of a thorough urological assessment of all men seeking medical help for fertility problems to ensure appropriate treatment. The guidelines also stress the clinical relevance of a parallel investigation of the female partner during the diagnostic and management work-up of the infertile couple, to promote shared-decision making in terms of timing and therapeutic strategies. Furthermore, the guidelines recommend to counsel all infertile men and men with abnormal semen parameters on the associated health risks. Key changes in the male infertility guidelines for 2025 include: the addition of two new sections addressing exome sequencing and probiotic treatment; and significant update of the evidence base and recommendations for the diagnostic work-up of male infertility.<h3>Conclusions and clinical implications</h3>This overview of the 2025 SHR guidelines offers valuable insights into the diagnosis, classification, treatment and follow-up of male factor infertility and are designed for effective integration into clinical practice.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"28 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}