European urology最新文献

{"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 2025;87:619–21","authors":"Andrew J. Vickers, Karim Touijer","doi":"10.1016/j.eururo.2025.08.032","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.08.032","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":"65 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145241459","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: Semen Quality and Lifespan: A Study of 78 284 Men Followed for up to 50 Years","authors":"Walter D. Cardona Maya, Temidayo S. Omolaoye, Stefan S. du Plessis","doi":"10.1016/j.eururo.2025.09.4157","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4157","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"11 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229310","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: Rui M. Bernardino, Theodorus van der Kwast, Neil E. Fleshner. Intraductal Carcinoma and Cribriform Pattern in Prostate Cancer: Challenges and Emerging Perspectives. Eur Urol 2025;88:123–5","authors":"Nour Khalil, Guiseppe Maiolino, Eric Barret","doi":"10.1016/j.eururo.2025.09.4159","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4159","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"23 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229311","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":"Reply to Yafei Wang, Qianting Lu, and Xin Zhao’s Letter to the Editor re: Lars Holmberg, Hans Garmo, Sven-Olov Andersson, et al. Time Dependence of Outcomes in the SPCG-4 Randomized Trial Comparing Radical Prostatectomy and Watchful Waiting in Early Prostate Cancer. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2025.07.001","authors":"Lars Holmberg, Hans-Olov Adami, Anna Bill-Axelson","doi":"10.1016/j.eururo.2025.09.4151","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4151","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"17 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229302","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":"Reply to Awais Ayub, Numair Tariq, and Shahroz Baloch’s Letter to the Editor re: Guohua Zeng, Kehua Jiang, Shusheng Liu, et al. Flexible Ureteroscopy with a Flexible and Navigable Suction Ureteral Access Sheath Versus Mini-Percutaneous Nephrolithotomy for Treatment of 2–3 cm Renal Stones: An International, Multicenter, Randomized, Noninferiority Trial. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2025.06.001","authors":"Guohua Zeng, Steffi Kar Kei Yuen, Vineet Gauhar, Wei Zhu","doi":"10.1016/j.eururo.2025.09.4158","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4158","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"104 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145229300","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":"Reply to Nastasiia Artamonova and Isabel Heidegger’s Letter to the Editor re: Pao-Hwa Lin, Alanna D. Burwell, Edward L. Giovannucci, et al. Dietary Patterns in Prostate Cancer Prevention and Management: A Systematic Review of Prospective Cohort Studies and Randomized Clinical Trials. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2025.07.017","authors":"Pao-Hwa Lin, Alanna D. Burwell, Stephen J. Freedland","doi":"10.1016/j.eururo.2025.09.4156","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4156","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"5 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226701","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":"Cost-effectiveness Analysis of Treatments for Bacillus Calmette-Guérin–unresponsive Carcinoma in Situ of the Bladder","authors":"Amanda A. Myers, Ruchika Talwar, Zhigang Duan, Patrick Hensley, Yair Lotan, Stephen B. Williams, Amy N. Luckenbaugh, Roger Li, Wassim Kassouf, Andrea Necchi, Vignesh T. Packiam, Neal Shore, Gary D. Steinberg, J.Alfred Witjes, Bogdana Schmidt, Sima Porten, Noah M. Hahn, Kelly K. Bree, Iakovos Toumazis, Hui Zhao, Ashish M. Kamat","doi":"10.1016/j.eururo.2025.09.4137","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4137","url":null,"abstract":"<h3>Background and objective</h3>Treatment options for patients with “bacillus Calmette-Guérin (BCG)-unresponsive” disease who are ineligible for or refuse radical cystectomy (RC) are expanding. Given the lack of direct comparative data, we conducted a cost-effectiveness analysis to guide treatment selection.<h3>Methods</h3>We developed a Markov decision analytic model to assess five treatments: RC, nadofaragene, nogapendekin, pembrolizumab, and gemcitabine/docetaxel. Cost effectiveness was evaluated over a 5-yr period using a willingness-to-pay threshold of $100 000 per quality-adjusted life year from the US Medicare perspective. Three index patients with BCG-unresponsive carcinoma in situ (CIS) were assessed.<h3>Key findings and limitations</h3>For index patient 1, who is willing to try one line of therapy or proceed directly to RC, gemcitabine/docetaxel was the most cost-effective option. For index patient 2, open to two lines of therapy or upfront RC, RC was most cost effective. For index patient 3, willing to try up to two lines of US Food and Drug Administration (FDA)-approved therapy (pembrolizumab, nadofaragene, or nogapendekin) before RC, pembrolizumab was the most cost-effective option.<h3>Conclusions and clinical implications</h3>Current pricing of bladder-sparing treatments poses significant financial barriers for patients with BCG-unresponsive CIS. Gemcitabine/docetaxel is most cost effective when only one therapy line is considered before RC, although this varies by clinical scenario. Upfront RC is most cost effective for patients wanting to try up to two lines of therapy. For patients only willing to try FDA-approved options and unwilling to undergo upfront RC, pembrolizumab is the most cost-effective option. Our findings highlight the need for better treatment selection tools and more equitable pricing.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"45 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145216014","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":"Antibiotic Prophylaxis for Shockwave Lithotripsy: A Move Towards Stewardship and Individualised Care","authors":"Bhaskar K. Somani","doi":"10.1016/j.eururo.2025.09.4142","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4142","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"27 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145216017","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":"Development and Validation of a Novel Plasma Metabolomic Signature for the Detection of Renal Cell Carcinoma","authors":"Cong Huang, Guangxi Wang, Yuyao Yuan, Yang Zou, Xiaowei Tang, Heng Guo, Huajie Song, Wenzhi Gao, Aixiang Wang, Yanfei Yu, Ye Tian, Chunhua Chi, Aimei Dong, Haixia Li, Xuesong Li, Shiming He, Yuxin Yin, Liqun Zhou","doi":"10.1016/j.eururo.2025.09.4148","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4148","url":null,"abstract":"<h3>Background and objective</h3>Early diagnosis is critical for improving survival in renal cell carcinoma (RCC); yet, effective laboratory tests remain lacking. We aimed to characterise metabolic reprogramming in RCC and develop an artificial intelligence (AI)-enabled plasma metabolic model for RCC detection.<h3>Methods</h3>In this multicentre diagnostic model development and validation study, plasma samples from RCC patients and healthy controls (HCs) were collected across five hospitals between December 2019 and October 2023. Eligible patients had pathologically confirmed RCC without prior treatment; HCs were recruited from routine physical examination. Participants with a history of malignancy were excluded. Untargeted plasma metabolomics was conducted to identify candidate metabolites via a support vector machine, further confirmed by a high-resolution targeted metabolic analysis. An AI-aided diagnostic model, Renal Cell Carcinoma Artificial Intelligence Detector (RCAID), was developed using selected metabolites and validated in six independent validation cohorts. Multiomic analyses were performed to elucidate the underlying metabolic mechanisms.<h3>Key findings and limitations</h3>The study enrolled 1680 participants, comprising 920 RCC patients and 760 HCs. Among RCC cases, 744 (81%) had clear cell RCC and 633 (69%) had stage I disease. Seven key plasma metabolites, including 2-hydroxyphenylacetic acid, azelaic acid, N,N-dimethylglycine, N-acetyl-L-aspartic acid, N-epsilon-acetyl-L-lysine, proline, and (Z,Z)-4-oxo-2,5-hetpadienedioic acid, were identified and used to develop the RCAID model, which demonstrated an area under the receiver operating characteristic curve (AUROC) of 0.988 in the training cohort (<em>n</em> = 503). The model exhibited excellent diagnostic performance, with AUROCs of 0.977, 0.911, 0.945, and 0.972 in the internal (<em>n</em> = 202), external (<em>n</em> = 158), multicentre (<em>n</em> = 346), and temporal (<em>n</em> = 123) validation cohorts, respectively. Additionally, RCAID achieved an AUROC of 0.940 in the late-stage RCC (<em>n</em> = 179) and 0.932 in the non–clear cell RCC (<em>n</em> = 169) validation cohorts. Multiomic analyses further revealed six RCAID-associated dysregulated metabolic pathways in RCC.<h3>Conclusions and clinical implications</h3>This study identified metabolic alterations in RCC and developed a promising AI-based plasma metabolic model with potential clinical application for RCC diagnosis.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"120 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226707","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":"Best Systemic Therapy With or Without Radical Prostatectomy in the Management of Men With Oligometastatic Prostate Cancer: The RAMPP Randomised Controlled Trial","authors":"Markus Graefen, Fabian Falkenbach, Tobias Maurer, Lars Budäus, Derya Tilki, Pierre I. Karakiewicz, Markus Aly, Peter Wiklund, Klaus Brasso, Andreas Røder, Mads H. Poulsen, Martin Schostak, Christiane Görtzen, Anke Renter, Gunhild von Amsberg, Alexander Haese, Hans Heinzer, Georg Salomon, Thomas Steuber, Burkhard Beyer","doi":"10.1016/j.eururo.2025.09.4144","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.09.4144","url":null,"abstract":"<h3>Background and objective</h3>Our aim was to evaluate the effect of addition of radical prostatectomy (RP) to best systemic therapy (BST) on cancer-specific mortality (CSM) in patients with oligometastatic prostate cancer (omPC).<h3>Methods</h3>This randomised controlled trial included patients with omPC with a low metastatic burden (1–5 bone metastases with/without nodal involvement) on conventional or PET imaging. Patients were randomised to receive either RP with pelvic lymph-node dissection plus BST (RP + BST) or BST alone. The primary endpoint was CSM. Secondary endpoints included clinical progression and overall survival (OS). Study accrual was stopped early because of a change in medical practice. Statistical analyses included cumulative incidence plots, Gray’s test, competing-risks regression, Kaplan-Meier estimates, and log-rank tests.<h3>Key findings and limitations</h3>Between May 2015 and December 2018, 132 patients were randomised. The median age was 67 yr (interquartile range 63–71) and median prostate-specific antigen was 20 ng/ml (interquartile range 10–39). The 5-yr CSM cumulative incidence was 13% for RP + BST and 23% for BST alone (<em>p</em> = 0.037), with a hazard ratio of 0.39 (95% confidence interval 0.16–0.98; <em>p</em> = 0.045). The 5-yr cumulative incidence of clinical progression including CSM was 59% for RP + BST and 60% for BST alone. The 5-yr OS rate was 81% for RP + BST and 74% for BST alone. Clavien-Dindo grade ≥III surgery-related complications occurred in nine of 66 (14%) patients in the RP + BST arm. Limitations include early discontinuation of study accrual and the lack of statistical significance for the OS benefit.<h3>Conclusions and clinical implications</h3>While this trial has substantial limitations, the results support addition of RP as local therapy to BST in omPC.<br/>This trial is registered on ClinicalTrials.gov as NCT02454543.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"53 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145216015","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}