European urology最新文献

{"title":"Glypican-3 as a Radiotheranostic Target for Neuroendocrine Prostate Cancer","authors":"Woonghee Lee, Joon-Yong Chung, Kwamena E. Baidoo, Divya Nambiar, Falguni Basuli, Ilsa Coleman, Martin Bakht, Chennan Li, Jinho Shin, Se Un Jeong, Yong Mee Cho, Himisha Beltran, Peter S. Nelson, Adam G. Sowalsky, Peter L. Choyke, Freddy E. Escorcia","doi":"10.1016/j.eururo.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.05.007","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"58 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144104042","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":"Characterization of Patients with Lymph Node Only Metastatic Urothelial Carcinoma Treated with Nivolumab Plus Gemcitabine-Cisplatin Versus Gemcitabine-Cisplatin Alone from the CheckMate 901 Trial","authors":"Matthew D. Galsky, Michiel S. van der Heijden, Thomas Powles, Melanie Claps, Mauricio Burotto, Michael Schenker, Juan Pablo Sade, Aristotelis Bamias, Philippe Beuzeboc, Jens Bedke, Jan Oldenburg, Yüksel Ürün, Dingwei Ye, Begoña P. Valderrama, Yoshihiko Tomita, Ruiyun Jiang, Jeiry Filian, Lily Wang, Maximiliano van Kooten Losio, Guru Sonpavde","doi":"10.1016/j.eururo.2025.04.019","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.04.019","url":null,"abstract":"Nivolumab (NIVO) plus gemcitabine-cisplatin (GC) demonstrated deep, durable responses in patients with untreated unresectable or metastatic urothelial carcinoma (mUC) with superior overall (OS) and progression-free (PFS) survival versus GC alone. We report post hoc exploratory analyses with 33.6 mo of median follow-up in patients with lymph node (LN) only disease from CheckMate 901. In this phase 3 randomized trial (<em>n</em> = 608), cisplatin-eligible patients received NIVO 360 mg plus GC every 3 wk (Q3W) for six or fewer cycles followed by NIVO 480 mg every 4 wk for ≤2 yr, or GC Q3W for six or fewer cycles. The primary endpoints were OS and PFS by a blinded independent central review (BICR). The objective response rate (ORR) as per the BICR and safety were exploratory. This post hoc analysis evaluated patients with LN only mUC (<em>n</em> = 110). In this subgroup, OS (hazard ratio [HR], 0.58; 95% confidence interval [CI] 0.34–1.00) and PFS (HR, 0.38; 95% CI 0.22–0.66) improved with NIVO + GC versus GC. The ORR was 81% with NIVO + GC versus 64% with GC; complete response rates were 63% versus 34%. The incidence of treatment-related adverse events was similar between arms. In conclusion, clinically meaningful improvements in OS, PFS, and ORR, including twice the rate of complete response and more patients with treatment-free intervals, were observed with NIVO + GC versus GC in patients with LN only disease, providing additional support for first-line NIVO plus cisplatin-based chemotherapy in mUC.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"15 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144097343","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: Invasive Urodynamic Investigations in the Management of Women with Refractory Overactive Bladder Symptoms (FUTURE) in the UK: A Multicentre, Superiority, Parallel, Open-label, Randomised Controlled Trial","authors":"Maurizio Serati, Tufan Tarcan, Benoit Peyronnet, Enrico Finazzi Agrò","doi":"10.1016/j.eururo.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.05.016","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"234 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144097613","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 Role of Prostate-specific Membrane Antigen Positron Emission Tomography for Assessment of Local Recurrence and Distant Metastases in Patients with Biochemical Recurrence of Prostate Cancer After Definitive Treatment: A Systematic Review and Meta-analysis","authors":"Elio Mazzone, Alice Thomson, David C. Chen, Donato Cannoletta, Leonardo Quarta, Antony Pellegrino, Giorgio Gandaglia, Daniel Moon, Renu Eapen, Nathan Lawrentschuk, Francesco Montorsi, Shankar Siva, Michael S. Hofman, Arturo Chiti, Alberto Briganti, Marlon L. Perera, Declan G. Murphy","doi":"10.1016/j.eururo.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.05.006","url":null,"abstract":"<h3>Background and objective</h3>Positron emission tomography (PET) with prostate-specific membrane antigen (PSMA) radioligands has an established role in the assessment of recurrence of prostate cancer (PC) after primary treatment. However, an updated understanding of its diagnostic utility is warranted, particularly in the context of emerging targeted and systemic treatment options for recurrent PC. Our aim was to evaluate the diagnostic performance of PSMA PET for staging and detection of local or metastatic disease in patients with biochemical recurrence (BCR) following definitive treatment for PC.<h3>Methods</h3>We conducted a systematic review (Web of Science/MEDLINE, Cochrane Library, and EMBASE from inception to April 25, 2024) and meta-analysis. Eligible retrospective and prospective studies had extractable data on PSMA PET for patients with BCR after radical prostatectomy (RP) or radiation therapy (RT). Risk of bias was assessed using the QUADAS-2 tool. Random-effects models were used to evaluate PSMA PET positivity rates across clinical subgroups stratified by PSA, primary treatment, PSMA PET radioligand, and anatomic lesion sites.<h3>Key findings and limitations</h3>A total of 43 studies (8119 patients) were included. PSMA PET positivity rates varied substantially among patients with BCR after primary definitive treatment, with significant study heterogeneity (τ² = 0.6; <em>p</em> &lt; 0.001), which was mitigated in part after stratification by PSA category. Positivity rates were significantly higher after RT (92%) than after RP (60%; <em>p</em> &lt; 0.001). PSMA PET positivity by anatomic location was 23% for local recurrence, 32% for pelvic nodes, 14% for extrapelvic nodes, 16% for bone metastases, and just 1% for visceral metastases. The positivity rate increased with PSA, from 48% at PSA 0.2–0.5 ng/ml to &gt;90% at PSA &gt;2 ng/ml. Gleason score (GS) at RP did not significantly influence the positivity rate (50% for GS ≤7 vs 62% for GS 8–10; <em>p</em> = 0.08). Heterogeneity limits the generalisability of our findings.<h3>Conclusions and clinical implications</h3>We observed substantial variability in PSMA PET positivity rates in BCR because of significant study heterogeneity, mostly related to differences in treatment type, PSA, and anatomic sites. In post-RP BCR, approximately half of patients undergoing PSMA PET had positive findings, even at low PSA (0.2–0.5 ng/ml). In the post-RT setting, PSMA PET use was generally aligned with the Phoenix criterion for BCR, with most studies performing PSMA PET at PSA ≥2 ng/ml. Further research is needed to refine PSA thresholds for PSMA PET, particularly in the post-RT setting, and to assess its role in guiding salvage treatment decisions.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"32 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144097463","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":"Prostate Cancer Active Surveillance Without Biopsy? Not Quite Yet, but Watch This Space","authors":"Matthew R. Cooperberg","doi":"10.1016/j.eururo.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.05.008","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"12 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144097344","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":"Robotic Transvesical Bladder Neck Reconstruction: A Novel Approach to Managing Vesicourethral Anastomotic Stenosis","authors":"Matthew Lee, Michael Lesgart, Connor McPartland, Randall Lee, Daniel D. Eun","doi":"10.1016/j.eururo.2025.04.026","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.04.026","url":null,"abstract":"<h3>Background and objective</h3>Our aim was to investigate outcomes of a novel robotic transvesical approach for bladder neck reconstruction in the surgical management of vesicourethral anastomotic stenosis (VUAS).<h3>Methods</h3>We performed a retrospective review of our single-institution database of robotic bladder neck reconstruction procedures to identify all consecutive patients who underwent robotic transvesical bladder neck reconstruction (RTV-BNR) for definitive management of VUAS between 2021 and 2024. The surgical technique involves circumferential excision of fibrotic scar tissue and creation of a mucosa-to-mucosa, watertight, tension-free anastomosis between the bladder neck mucosa and posterior urethra via a posterior transvesical approach. The primary outcome was surgical success, defined as patients who did not require any additional surgical reintervention for recurrent stenosis after the initial procedure. Secondary outcomes included de novo stress urinary incontinence (SUI) and major (Clavien grade &gt;2) postoperative complications.<h3>Key findings and limitations</h3>Eleven patients met the inclusion criteria. Two patients (18%) had a history of salvage radiotherapy before RTV-BNR. All strictures were &lt;2 cm in length. The median operative time was 189 min (interquartile range [IQR] 122–248) and median estimated blood loss was 100 ml (IQR 50–100). None of the patients developed de novo SUI. At median follow-up of 22 mo (IQR 14–30), the surgery was successful in ten patients (91%). Major limitations of the study are its retrospective nature, small sample size, and lack of a direct comparison to outcomes with established techniques for VUAS management.<h3>Conclusions and clinical implications</h3>RTV-BNR is an innovative technique that may offer a safe and effective approach for VUAS management.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"60 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144097461","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":"Erectile Dysfunction: Update on Clinical Management","authors":"Paolo Capogrosso, Maarten Albersen, Arthur L. Burnett, Onur Omer Cakir, Federico Dehó, Luís Afonso Morgado, John Mulhall, Andrea Salonia, Ahmet Furkan Sarikaya, Maria Satchi, Ege Can Serefoglu, Maj Shabbir, Ioannis Sokolakis, Tet Yap, Fabio Castiglione","doi":"10.1016/j.eururo.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.05.004","url":null,"abstract":"<h3>Background and objective</h3>Erectile dysfunction (ED) is a common condition affecting patients’ quality of life. Clinical management has changed over the past three decades, with new diagnostic and therapeutic options available. Our aim was to provide an overview of novel evidence regarding clinical management of ED.<h3>Methods</h3>A non-systematic literature review was conducted to identify relevant studies on the diagnosis and treatment of erectile dysfunction. The review encompassed pharmacological, regenerative, and surgical approaches, summarising recent advances and highlighting persisting gaps in clinical practice.<h3>Key findings and limitations</h3>ED is a common reason for seeking medical consultation. The correlation between ageing and ED prevalence is rooted in neurovascular tissue impairment. Medical history, along with the use of validated questionnaires, still represents the mainstay of ED assessment because of the lack of reliable imaging tests. The most widely used and effective treatment is an oral phosphodiesterase type 5 inhibitor, but this is lifelong therapy that is associated with high dropout rates. Among novel regenerative treatments, low-intensity shockwave therapy is supported by more evidence, although high-quality trials and long-term data are lacking. More conclusive evidence is needed for platelet-rich plasma injections and stem cell treatment. Botulinum neurotoxin and new emerging oral drugs are also under investigation.<h3>Conclusions</h3>Several treatment options are available for ED. Clinical tailoring of treatment for individual patients and rigorous research are crucial for further advances.<h3>Patient summary</h3>Erectile dysfunction (ED) is a common medical problem. Various types of treatment can improve ED, but there is still no cure for this condition.","PeriodicalId":12223,"journal":{"name":"European urology","volume":"2 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144097585","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: Randomized Comparison of Magnetic Resonance Imaging Versus Transurethral Resection for Staging New Bladder Cancers: Results from the Prospective BladderPath Trial","authors":"Christian Daniel Fankhauser, Richard Cathomas","doi":"10.1016/j.eururo.2025.05.011","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.05.011","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"32 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144097612","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: Preventative Function-sparing Radical Prostatectomy: Experience in a Tertiary Referral Centre","authors":"Jan Adamowicz, Krzysztof Koper, Tomasz Drewa","doi":"10.1016/j.eururo.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.05.009","url":null,"abstract":"No Abstract","PeriodicalId":12223,"journal":{"name":"European urology","volume":"24 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067299","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 Critical Role of FLCN, TFE3, and TFEB in Bioenergetic and Nutrient Sensing, Renal Cancer Tumorigenesis and Metabolic Health","authors":"W. Marston Linehan, Christopher J. Ricketts, Daniel R. Crooks, Laura S. Schmidt","doi":"10.1016/j.eururo.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.eururo.2025.05.003","url":null,"abstract":"<h2>Section snippets</h2><section><section><h2>FLCN function</h2>FLCN is an ancient cellular bioenergetic and nutrient sensor that controls activation of the TFE3 and TFEB transcription factors and regulates lysosomal and mitochondrial biogenesis and function. FLCN, and its binding partner FNIP1, act as a GTP-activating protein (GAP) for the small GTPase Ras-related GTP-binding protein C (RagC). FLCN and FNIP activate a noncanonical mTORC1 signaling pathway that leads to phosphorylation of members of the microphthalmia/transcription factor E (MiT/TFE) family</section></section><section><section><h2><em>FLCN</em> mutation in BHD RCC</h2>BHD-associated hybrid RCC, chromophobe RCC, and oncocytoma tumors are characterized by biallelic inactivation of <em>FLCN</em> due to a combination of the germline pathogenic variation and somatic loss of function of the remaining allele via “second hit” mutation or deletion events. FLCN loss in BHD renal tumors leads to dephosphorylation and nuclear translocation of TFE3 [7] and TFEB, resulting in increased lysosomal and mitochondrial biogenesis (Fig. 1D). This is reflected in immunohistochemical</section></section><section><section><h2>Dysregulation of MiT/TFE transcription factors in renal cancer</h2>Activation of TFE3 and/or TFEB is recognized as an important driver event in many different types of renal cancer, including sporadic RCC's resulting from somatic TFE3/TFEB translocation or amplification of TFEB, as well as hereditary RCCs caused by germline variants in <em>MITF</em>, <em>TSC1</em>, <em>TSC2</em>, and <em>PRDM10</em>. These tumor types demonstrate overlapping histologies with BHD-associated RCCs, with TFE3/TFEB translocation RCC and PRDM10-associated RCC strongly reflecting the rarer but more aggressive</section></section><section><section><h2>Clinical management and therapy</h2>Identification of the <em>FLCN</em> gene, which was made possible by studying patients affected by BHD, has enabled clinicians to improve clinical management and surgical care for these patients. It also provides a foundation for the development of therapeutic or preventive approaches for BHD using small molecules that target TFE3/TFEB stability, agents targeting PGC1α transcriptional activity, antibody-drug conjugates and CAR-T cell therapies targeting cell-surface GPNMB expression.</section></section><section><section><h2>Implications of the physiologic role of FLCN on metabolic health</h2>As a sensor of bioenergetic and nutrient stress, FLCN is thought to potentially have significant importance in human health. FLCN is likely to play a critical role in the body’s response to exercise and restriction of caloric intake on long-term health. Gosis et al [8] showed that a decrease in FLCN in the liver could reverse nonalcoholic fatty liver disease and nonalcoholic steatohepatitis in animals fed a diet high in fructose, cholesterol, and trans fats. Zhang et al [9] demonstrated that</section></section>","PeriodicalId":12223,"journal":{"name":"European urology","volume":"30 1","pages":""},"PeriodicalIF":23.4,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144067384","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}