European urology最新文献

{"title":"Membranous expression of target protein is required for ADC response in urothelial cancer","authors":"Niklas Klümper , Johannes Brägelmann , Veronika Bahlinger , Arndt Hartmann , Viktor Grünwald , Christoph Kuppe , Michael Hölzel , Markus Eckstein","doi":"10.1016/j.eururo.2024.06.023","DOIUrl":"10.1016/j.eururo.2024.06.023","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages e34-e36"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876978","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: Iver Nordentoft, Sia Viborg Lindskrog, Karin Birkenkamp-Demtröder, et al. Whole-genome Mutational Analysis for Tumor-informed Detection of Circulating Tumor DNA in Patients with Urothelial Carcinoma. Eur Urol. 2024;86:301–311","authors":"Xiaoliang Wu , Xiangyang Yao , Zhong Chen , Hua Xu","doi":"10.1016/j.eururo.2024.07.021","DOIUrl":"10.1016/j.eururo.2024.07.021","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages e36-e37"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141908692","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: Prostate Cancers in the Prostate-specific Antigen Interval of 1.8-3 ng/ml: Results from the Göteborg-2 Prostate Cancer Screening Trial","authors":"Ola Bratt","doi":"10.1016/j.eururo.2024.08.006","DOIUrl":"10.1016/j.eururo.2024.08.006","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages 268-269"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997095","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":"Impact of Gene Expression Classifier Testing on Adjuvant Treatment Following Radical Prostatectomy: The G-MINOR Prospective Randomized Cluster-crossover Trial","authors":"Todd M. Morgan ,&nbsp;Stephanie Daignault-Newton ,&nbsp;Daniel E. Spratt ,&nbsp;Rodney L. Dunn ,&nbsp;Udit Singhal ,&nbsp;Linda A. Okoth ,&nbsp;Felix Y. Feng ,&nbsp;Anna M. Johnson ,&nbsp;Brian R. Lane ,&nbsp;Susan Linsell ,&nbsp;Khurshid R. Ghani ,&nbsp;James E. Montie ,&nbsp;Rohit Mehra ,&nbsp;Brent K. Hollenbeck ,&nbsp;Thomas Maatman ,&nbsp;Kirk Wojno ,&nbsp;Frank N. Burks ,&nbsp;Daniel Bekong ,&nbsp;Jon Curry ,&nbsp;Paul Rodriguez ,&nbsp;Michael L. Cher","doi":"10.1016/j.eururo.2024.09.011","DOIUrl":"10.1016/j.eururo.2024.09.011","url":null,"abstract":"<div><h3>Background and objective</h3><div>Decipher is a tissue-based genomic classifier (GC) developed and validated in the post–radical prostatectomy (RP) setting as a predictor of metastasis. We conducted a prospective randomized controlled cluster-crossover trial assessing the use of Decipher to determine its impact on adjuvant treatment after RP.</div></div><div><h3>Methods</h3><div>Eligible patients had undergone RP within 9 mo of enrollment, had pT3–4 disease and/or positive surgical margins, and prostate-specific antigen &lt;0.1 ng/ml. Centers were randomized to a sequence of 3-mo periods of either GC-informed care or usual care (UC). Cancer of the Prostate Risk Assessment Postsurgical (CAPRA-S) recurrence risk scores were provided to treating physicians and patients in all periods.</div></div><div><h3>Key findings and limitations</h3><div>Impact of GC test results on adjuvant treatment were compared with UC alone. Longitudinal patient-reported urinary and sexual function was assessed. A total of 175 patients were enrolled in 27 periods with GC and 163 in 28 periods with UC. At 18 mo after RP, an average patient in the GC arm received adjuvant treatment 9.7% of the time compared with 8.7% for an average individual in the UC arm (0.99% mean difference, 95% confidence interval [CI] –7.6%, 9.6%, <em>p</em> = 0.8). While controlling for CAPRA-S score, higher GC scores tended to result in an increased likelihood of adjuvant treatment that was not statistically significant (odds ratio [OR] = 1.35 per 0.1 increase in GC score, 95% CI 0.98–1.85, <em>p</em> = 0.066). Using the GC risk groups, reflecting clinical use, a high GC risk was associated with significantly higher odds of receiving adjuvant treatment (OR = 6.9, 95% CI 1.8, 26, <em>p</em> = 0.005) compared with a low GC score, adjusted for CAPRA-S score. There were no differences in patient-reported urinary and sexual function between the study arms. As oncologic outcomes are immature, the present data cannot address whether GC testing provides any cancer control benefit.</div></div><div><h3>Conclusions and clinical implications</h3><div>GC testing impacts adjuvant therapy administration when viewed through the risk categories presented in the patient report; however, these data do not provide specific support for GC testing in the adjuvant treatment setting.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages 228-237"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142384489","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":"Despite an Abundance of Active Treatment Options for Renal Cell Carcinoma, Shadows Still Obscure the Light","authors":"Camillo Porta ,&nbsp;Carlo Ganini ,&nbsp;Mimma Rizzo","doi":"10.1016/j.eururo.2024.11.005","DOIUrl":"10.1016/j.eururo.2024.11.005","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages 155-156"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142735730","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":"Biparametric Versus Multiparametric Magnetic Resonance Imaging in Prostate Cancer: A Choice or a Fine Balance?","authors":"Adriano B. Dias ,&nbsp;Caroline M. Moore ,&nbsp;Raphaële Renard-Penna ,&nbsp;Francesco Giganti","doi":"10.1016/j.eururo.2024.11.022","DOIUrl":"10.1016/j.eururo.2024.11.022","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages 251-252"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142832772","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":"Oncological Benefits of Extended Pelvic Lymph Node Dissection: More Fog or Clarity to the Debate?","authors":"Matthew J. Roberts ,&nbsp;Philip Cornford ,&nbsp;Derya Tilki","doi":"10.1016/j.eururo.2024.12.001","DOIUrl":"10.1016/j.eururo.2024.12.001","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages 261-263"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884105","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":"Refining Risk Stratification of High-risk and Locoregional Prostate Cancer: A Pooled Analysis of Randomized Trials","authors":"Praful Ravi ,&nbsp;Wanling Xie ,&nbsp;Marc Buyse ,&nbsp;Susan Halabi ,&nbsp;Philip W. Kantoff ,&nbsp;Oliver Sartor ,&nbsp;Gert Attard ,&nbsp;Noel Clarke ,&nbsp;Anthony D'Amico ,&nbsp;James Dignam ,&nbsp;Nicholas James ,&nbsp;Karim Fizazi ,&nbsp;Silke Gillessen ,&nbsp;Wendy Parulekar ,&nbsp;Howard Sandler ,&nbsp;Daniel E. Spratt ,&nbsp;Matthew R. Sydes ,&nbsp;Bertrand Tombal ,&nbsp;Scott Williams ,&nbsp;Christopher J. Sweeney","doi":"10.1016/j.eururo.2024.04.038","DOIUrl":"10.1016/j.eururo.2024.04.038","url":null,"abstract":"<div><h3>Background and objective</h3><div>Radiotherapy (RT) and long-term androgen deprivation therapy (ltADT; 18–36 mo) is a standard of care in the treatment of high-risk localized/locoregional prostate cancer (HRLPC). We evaluated the outcomes in patients treated with RT + ltADT to identify which patients have poorer prognosis with standard therapy.</div></div><div><h3>Methods</h3><div>Individual patient data from patients with HRLPC (as defined by any of the following three risk factors [RFs] in the context of cN0 disease—Gleason score ≥8, cT3–4, and prostate-specific antigen [PSA] &gt;20 ng/ml, or cN1 disease) treated with RT and ltADT in randomized controlled trials collated by the Intermediate Clinical Endpoints in Cancer of the Prostate group. The outcome measures of interest were metastasis-free survival (MFS), overall survival (OS), time to metastasis, and prostate cancer-specific mortality. Multivariable Cox and Fine-Gray regression estimated hazard ratios (HRs) for the three RFs and cN1 disease.</div></div><div><h3>Key findings and limitations</h3><div>A total of 3604 patients from ten trials were evaluated, with a median PSA value of 24 ng/ml. Gleason score ≥8 (MFS HR = 1.45; OS HR = 1.42), cN1 disease (MFS HR = 1.86; OS HR = 1.77), cT3–4 disease (MFS HR = 1.28; OS HR = 1.22), and PSA &gt;20 ng/ml (MFS HR = 1.30; OS HR = 1.21) were associated with poorer outcomes. Adjusted 5-yr MFS rates were 83% and 78%, and 10-yr MFS rates were 63% and 53% for patients with one and two to three RFs, respectively; corresponding 10-yr adjusted OS rates were 67% and 60%, respectively. In cN1 patients, adjusted 5- and 10-yr MFS rates were 67% and 36%, respectively, and 10-yr OS was 47%.</div></div><div><h3>Conclusions and clinical implications</h3><div>HRLPC patients with two to three RFs (and cN0) or cN1 disease had the poorest outcomes on RT and ltADT. This will help in counseling patients treated in routine practice and in guiding adjuvant trials in HRLPC.</div></div><div><h3>Patient summary</h3><div>Radiotherapy and long-term hormone therapy are standard treatments for high-risk and locoregional prostate cancer. In this report, we defined prognostic groups within high-risk/locoregional prostate cancer and showed that outcomes to standard therapy are poorest in those with two or more “high-risk” factors or evidence of lymph node involvement. Such patients may therefore be the best candidates for intensification of treatment.</div></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages 217-224"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080634","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":"Evaluating Biparametric Versus Multiparametric Magnetic Resonance Imaging for Diagnosing Clinically Significant Prostate Cancer: An International, Paired, Noninferiority, Confirmatory Observer Study","authors":"Jasper J. Twilt ,&nbsp;Anindo Saha ,&nbsp;Joeran S. Bosma ,&nbsp;Bram van Ginneken ,&nbsp;Anders Bjartell ,&nbsp;Anwar R. Padhani ,&nbsp;David Bonekamp ,&nbsp;Geert Villeirs ,&nbsp;Georg Salomon ,&nbsp;Gianluca Giannarini ,&nbsp;Jayashree Kalpathy-Cramer ,&nbsp;Jelle Barentsz ,&nbsp;Klaus H. Maier-Hein ,&nbsp;Mirabela Rusu ,&nbsp;Olivier Rouvière ,&nbsp;Roderick van den Bergh ,&nbsp;Valeria Panebianco ,&nbsp;Veeru Kasivisvanathan ,&nbsp;Nancy A. Obuchowski ,&nbsp;Derya Yakar ,&nbsp;Young Joon Lee","doi":"10.1016/j.eururo.2024.09.035","DOIUrl":"10.1016/j.eururo.2024.09.035","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and objective&lt;/h3&gt;&lt;div&gt;Biparametric magnetic resonance imaging (bpMRI), excluding dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI), is a potential replacement for multiparametric MRI (mpMRI) in diagnosing clinically significant prostate cancer (csPCa). An extensive international multireader multicase observer study was conducted to assess the noninferiority of bpMRI to mpMRI in csPCa diagnosis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;An observer study was conducted with 400 mpMRI examinations from four European centers, excluding examinations with prior prostate treatment or csPCa (Gleason grade [GG] ≥2) findings. Readers assessed bpMRI and mpMRI sequentially, assigning lesion-specific Prostate Imaging Reporting and Data System (PI-RADS) scores (3–5) and a patient-level suspicion score (0–100). The noninferiority of patient-level bpMRI versus mpMRI csPCa diagnosis was evaluated using the area under the receiver operating curve (AUROC) alongside the sensitivity and specificity at PI-RADS ≥3 with a 5% margin. The secondary outcomes included insignificant prostate cancer (GG1) diagnosis, diagnostic evaluations at alternative risk thresholds, decision curve analyses (DCAs), and subgroup analyses considering reader expertise. Histopathology and ≥3 yr of follow-up were used for the reference standard.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Key findings and limitations&lt;/h3&gt;&lt;div&gt;Sixty-two readers (45 centers and 20 countries) participated. The prevalence of csPCa was 33% (133/400); bpMRI and mpMRI showed similar AUROC values of 0.853 (95% confidence interval [CI], 0.819–0.887) and 0.859 (95% CI, 0.826–0.893), respectively, with a noninferior difference of –0.6% (95% CI, –1.2% to 0.1%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001). At PI-RADS ≥3, bpMRI and mpMRI had sensitivities of 88.6% (95% CI, 84.8–92.3%) and 89.4% (95% CI, 85.8–93.1%), respectively, with a noninferior difference of –0.9% (95% CI, –1.7% to 0.0%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001), and specificities of 58.6% (95% CI, 52.3–63.1%) and 57.7% (95% CI, 52.3–63.1%), respectively, with a noninferior difference of 0.9% (95% CI, 0.0–1.8%, &lt;em&gt;p&lt;/em&gt; &lt; 0.001). At alternative risk thresholds, mpMRI increased sensitivity at the expense of reduced specificity. DCA demonstrated the highest net benefit for an mpMRI pathway in cancer-averse scenarios, whereas a bpMRI pathway showed greater benefit for biopsy-averse scenarios. A subgroup analysis indicated limited additional benefit of DCE MRI for nonexperts. Limitations included that biopsies were conducted based on mpMRI imaging, and reading was performed in a sequential order.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions and clinical implications&lt;/h3&gt;&lt;div&gt;It has been found that bpMRI is noninferior to mpMRI in csPCa diagnosis at AUROC, along with the sensitivity and specificity at PI-RADS ≥3, showing its value in individuals without prior csPCa findings and prostate treatment. Additional randomized prospective studies are required to investigate the generalizability of outcomes.&lt;","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages 240-250"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142486552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography for Nodal Staging in Prostate Cancer and Tailoring of Treatment: A Continuing Conundrum","authors":"Johan Stranne ,&nbsp;Ann Henry ,&nbsp;Daniela E. Oprea-Lager ,&nbsp;EAU-EANM-ESTRO-ESUR-ISUP-SIOG Prostate Cancer Guidelines Panel","doi":"10.1016/j.eururo.2024.11.025","DOIUrl":"10.1016/j.eururo.2024.11.025","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"87 2","pages":"Pages 108-109"},"PeriodicalIF":25.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841077","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}