European urology最新文献

{"title":"Population-based Screening for Prostate Cancer: Is it Time?","authors":"Jonas Hugosson","doi":"10.1016/j.eururo.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.11.003","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"19 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678604","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: Radical Prostatectomy or Watchful Waiting in Early Prostate Cancer","authors":"Philipp Dahm, Timothy J. Wilt","doi":"10.1016/j.eururo.2024.10.025","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.10.025","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"19 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142642701","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":"Molecular Heterogeneity and Immune Infiltration Drive Clinical Outcomes in Upper Tract Urothelial Carcinoma","authors":"Kwanghee Kim, Syed M. Alam, Fengshen Kuo, Ziyu Chen, Wesley Yip, Andrew B. Katims, Carissa Chu, Andrew T. Lenis, Wenhuo Hu, Gamze Gokturk Ozcan, Jie-Fu Chen, Sanaz Firouzi, Yuval Elhanati, Timothy N. Clinton, Andreas Aulitzky, Nima Almassi, Yoich Fujii, Andrew T. Tracey, Peter A. Reisz, Sadna Budhu, Jonathan A. Coleman","doi":"10.1016/j.eururo.2024.10.024","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.10.024","url":null,"abstract":"<h3>Background and objective</h3>Molecular classification of upper tract urothelial carcinoma (UTUC) can provide insight into divergent clinical outcomes and provide a biological rationale for clinical decision-making. As such, we performed multi-omic analysis of UTUC tumors to identify molecular features associated with disease recurrence and response to immune checkpoint blockade (ICB).<h3>Methods</h3>Targeted DNA and whole transcriptome RNA sequencing was performed on 100 UTUC tumors collected from patients undergoing nephroureterectomy. Consensus non-negative matrix factorization was used to identify molecular clusters associated with clinical outcomes. Gene set enrichment and immune deconvolution analyses were performed. Weighted gene co-expression network analysis was employed for unsupervised identification of gene networks in each cluster.<h3>Key findings and limitations</h3>Five molecular clusters with distinct clinical outcomes were identified. Favorable subtypes (C1 and C2) were characterized by a luminal-like signature and an immunologically depleted tumor microenvironment (TME). Subtype C3 was characterized by <em>FGFR3</em> alterations and a higher tumor mutational burden, and included all tumors with microsatellite instability. Despite higher rates of recurrence and inferior survival, subtypes C4 and C5 harbored an immunologically rich TME favoring response to ICB. Limitations include extrapolation of molecular features of tumors from the primary site to determine response to systemic immunotherapy and the limited resolution of bulk sequencing to distinguish gene expression in the tumor, stroma, and immune compartments.<h3>Conclusions and clinical implications</h3>RNA sequencing identified previously underappreciated UTUC molecular heterogeneity and suggests that UTUC patients at the highest risk of metastatic recurrence following surgery include those most likely to benefit from perioperative ICB.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"247 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142642699","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: Comprehensive Evaluation of the Ability of Comorbidity and Health Status Indices to Improve the Prediction of Perioperative Morbidity and Long-term Survival Outcomes After Radical Cystectomy","authors":"Alexander Lloyd, Patrick Y. Wuethrich, Christopher Soliman, Marc A. Furrer","doi":"10.1016/j.eururo.2024.10.030","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.10.030","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"8 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142642700","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: Adhesive Anti-fibrotic Interfaces on Diverse Organs","authors":"David D’Andrea, Shahrokh F. Shariat","doi":"10.1016/j.eururo.2024.10.029","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.10.029","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"72 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142609966","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":"Magnetic Resonance Imaging Versus Computed Tomography Guidance for Stereotactic Body Radiotherapy in Prostate Cancer: 2-year Outcomes from the MIRAGE Randomized Clinical Trial","authors":"Amar U. Kishan, James M. Lamb, Holly Wilhalme, Maria Casado, Natalie Chong, Lily Zello, Jesus E. Juarez, Tommy Jiang, Beth K. Neilsen, Daniel A. Low, Yingli Yang, John Neylon, Vincent Basehart, Ting Martin Ma, Luca F. Valle, Minsong Cao, Michael L. Steinberg","doi":"10.1016/j.eururo.2024.10.026","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.10.026","url":null,"abstract":"It has been shown that magnetic resonance imaging (MRI) guidance versus computed tomography (CT) guidance for aggressive margin-reduction (AMR) for stereotactic body radiotherapy (SBRT) in prostate cancer reduces acute toxicity, but the longer-term benefits are unknown. We performed a secondary analysis of MIRAGE, a phase 3 randomized clinical trial of MRI-guided SBRT for prostate cancer, to determine whether AMR with MRI guidance significantly reduced 2-yr physician-scored or patient-reported toxic effects in comparison to CT guidance. The cumulative incidence of 2-yr physician-scored toxicity, defined as grade ≥2 genitourinary (GU) and gastrointestinal (GI) toxic effects according to Common Terminology Criteria for Adverse Events v4.03, were lower with MRI guidance. Cumulative incidence rates of late grade ≥2 toxicity at 2 yr with MRI-guided versus CT-guided SBRT were 27% (95% confidence interval [CI] 19–39%)] versus 51% (95% CI 41–63%) for GU toxicity (<em>p</em> = 0.004), and 1.4% (95% CI 0.2–9.6) versus 9.5% (95% CI 4.6–19) for GI toxicity (<em>p</em> = 0.025). Cumulative logistic regression revealed that MRI-guided SBRT was associated with significantly lower odds of a clinically relevant deterioration in bowel function according to the Expanded Prostate Cancer Index Composite-26 score (odds ratio 0.444, 95% CI 0.209–0.942; <em>p</em> = 0.035) and in the Sexual Health Inventory in Men score (odds ratio 0.366, 95% CI 0.148–0.906; <em>p</em> = 0.03). There were no significant differences in the odds of a deterioration for other quality-of-life metrics. These findings support the hypothesis that aggressive planning for margin reduction for prostate SBRT using MRI leads to continued reductions in toxic effects over 2-yr follow-up.This trial is registered on ClinicalTrials.gov Identifier as NCT04384770.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"11251 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601206","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":"Epidemiology and Risk Factors for Testicular Cancer: A Systematic Review","authors":"Valentina Tateo, Zachary J. Thompson, Scott M. Gilbert, Victoria K. Cortessis, Siamak Daneshmand, Timothy A. Masterson, Darren R. Feldman, Phillip M. Pierorazio, Gagan Prakash, Axel Heidenreich, Peter Albers, Andrea Necchi, Philippe E. Spiess","doi":"10.1016/j.eururo.2024.10.023","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.10.023","url":null,"abstract":"<h3>Background and objective</h3>Testicular germ cell tumors (TGCTs) are globally rare, although incidence significantly varies across global geographic regions and ethnicities. Recent decades have seen an unexplained increase in incidence. This review investigates the changing epidemiology of TGCT and identifies key risk factors.<h3>Methods</h3>A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 statement was conducted. After screening and risk-of-bias assessment, 53 reports on significant and updated topics on TGCT epidemiology and risk factors were included for narrative synthesis. Of these, 26 were selected for quantitative synthesis.<h3>Key findings and limitations</h3>Projections suggest a continued increase in global TGCT incidence, even in populations with historically low incidence. Genetic predisposition, particularly single-nucleotide polymorphisms, accounts for approximately 44% of TGCT heritability. In utero exposure to endocrine-disrupting chemicals, cryptorchidism, infertility, high height, behavioral factors such as marijuana consumption, and environmental or occupational exposures to potentially harmful substances are associated with higher TGCT risk, with variable strength of evidence. Meta-analyses confirmed a significant association between prenatal/early-life risk factors and TGCT incidence (odds ratio 1.44). Limitations include constrained evidence quality, heterogeneity in study types, and a limited volume of data supporting each topic.<h3>Conclusions and clinical implications</h3>TGCT pathogenesis is influenced by genetic predisposition and exposures during early life. The rising incidence may reflect socioeconomic changes and migration patterns, which determine variation in population exposure to risk factors. TGCT epidemiology remains controversial and requires further research and the implementation of optimal screening programs considering the rising incidence and consequent impact on global health and socioeconomic systems.<h3>Advancing practice</h3><strong><em>What does this study add</em>?</strong> .<h3>Patient summary</h3>.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"22 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142609766","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: Duration of Androgen Deprivation Therapy with Postoperative Radiotherapy for Prostate Cancer: A Comparison of Long-course Versus Short-course Androgen Deprivation Therapy in the RADICALS-HD Randomised Trial","authors":"Pirus Ghadjar, Daniel Zips","doi":"10.1016/j.eururo.2024.10.028","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.10.028","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"159 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142601209","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 “Impact of Prostate-specific Membrane Antigen Positron Emission Tomography/Computed Tomography on Prostate Cancer Salvage Radiotherapy Management: Results from a Prospective Multicenter Randomized Phase 3 Trial (PSMA-SRT NCT03582774)” [Eur Urol. 86(1) (2024) 52–60]","authors":"Wesley R. Armstrong, Amar U. Kishan, Kiara M. Booker, Tristan R. Grogan, David Elashoff, Ethan C. Lam, Kevyn J. Clark, Michael L. Steinberg, Wolfgang P. Fendler, Thomas A. Hope, Nicholas G. Nickols, Johannes Czernin, Jeremie Calais","doi":"10.1016/j.eururo.2024.10.022","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.10.022","url":null,"abstract":"The authors regret about typological errors in the article found by Feng Qi as published in the letter to the editor of July 25, 2024 in European Urology.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"36 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142597140","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 and Second-line Treatments in Metastatic Renal Cell Carcinoma","authors":"Regina Barragan-Carrillo, Eddy Saad, Renee-Maria Saliby, Maxine Sun, Laurence Albiges, Axel Bex, Daniel Heng, Arnaud Mejean, Robert J. Motzer, Elizabeth R. Plimack, Thomas Powles, Brian I. Rini, Tian Zhang, Toni K. Choueiri","doi":"10.1016/j.eururo.2024.10.019","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.10.019","url":null,"abstract":"<h3>Background and objective</h3>The treatment landscape for metastatic renal cell carcinoma (mRCC) has evolved significantly in recent years, leading to improved outcomes. The aim of this review is to provide clinicians with a practical guide for selecting first- and second-line treatments on the basis of current evidence.<h3>Methods</h3>We critically evaluated systemic treatment strategies for mRCC. A comprehensive literature search was conducted in PubMed and Embase, alongside manual searches of guidelines and conference proceedings up to October 2024. A narrative review was performed to reach a consensus, with voting used to resolve differing opinions among authors.<h3>Key findings and limitations</h3>First-line treatment options include immune checkpoint inhibitor (ICI)-based combinations or tyrosine kinase inhibitors (TKIs). Four combination regimens have been approved internationally. Owing to the lack of head-to-head trials and standardized biomarkers, treatment decisions rely on factors such as International Metastatic RCC Database Consortium (IMDC) risk score, functional status, safety profiles, sarcomatoid features, use of immunosuppressive drugs, and need for immediate response. Despite advances, many patients will experience disease progression on ICI-based therapy, necessitating further treatment. The need for standardized second-line approaches remains unmet. TKIs, alone or with everolimus, show promising efficacy, while HIF2a inhibitors offer newer options with a favorable toxicity profile. Rechallenge with ICIs after early progression is not recommended.<h3>Conclusions and clinical implications</h3>For optimal mRCC treatment selection, clinicians must carefully balance efficacy, toxicity, and patient preferences, especially when transitioning between first- and second-line therapies, to provide individualized care.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"121 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142588328","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}