European urologyPub Date : 2024-09-01DOI: 10.1016/j.eururo.2024.04.022
{"title":"Decision Regret Regarding Treatment Choices 1 Year After a New Diagnosis of Bladder Cancer","authors":"","doi":"10.1016/j.eururo.2024.04.022","DOIUrl":"10.1016/j.eururo.2024.04.022","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":25.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913599","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}
European urologyPub Date : 2024-09-01DOI: 10.1016/j.eururo.2024.05.007
{"title":"Keep it Simple: A Proposal for a New Definition of Uncomplicated and Complicated Urinary Tract Infections from the EAU Urological Infections Guidelines Panel","authors":"","doi":"10.1016/j.eururo.2024.05.007","DOIUrl":"10.1016/j.eururo.2024.05.007","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":25.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140924083","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}
European urologyPub Date : 2024-09-01DOI: 10.1016/j.eururo.2024.04.035
{"title":"Re: Alonso Garcia-Ruiz, Carlos Macarro, Francesca Zacchi, et al. Whole-body Magnetic Resonance Imaging as a Treatment Response Biomarker in Castration-resistant Prostate Cancer with Bone Metastases: The iPROMET Clinical Trial. Eur Urol. In press. https://doi.org/10.1016/j.eururo.2024.02.016","authors":"","doi":"10.1016/j.eururo.2024.04.035","DOIUrl":"10.1016/j.eururo.2024.04.035","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":25.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961320","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}
European urologyPub Date : 2024-09-01DOI: 10.1016/j.eururo.2024.04.004
{"title":"Summary Paper on Underactive Bladder from the European Association of Urology Guidelines on Non-neurogenic Male Lower Urinary Tract Symptoms","authors":"","doi":"10.1016/j.eururo.2024.04.004","DOIUrl":"10.1016/j.eururo.2024.04.004","url":null,"abstract":"<div><h3>Background and objective</h3><p>The European Association of Urology (EAU) Guidelines Panel on non-neurogenic male lower urinary tract symptoms (LUTS) aimed to develop a new subchapter on underactive bladder (UAB) in non-neurogenic men to inform health care providers of current best evidence and practice. Here, we present a summary of the UAB subchapter that is incorporated into the 2024 version of the EAU guidelines on non-neurogenic male LUTS.</p></div><div><h3>Methods</h3><p>A systematic literature search was conducted from 2002 to 2022, and articles with the highest certainty evidence were selected. A strength rating has been provided for each recommendation according to the EAU Guideline Office methodology.</p></div><div><h3>Key findings and limitations</h3><p>Detrusor underactivity (DU) is a urodynamic diagnosis defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or failure to achieve complete bladder emptying within a normal time span. UAB is a terminology that should be reserved for describing symptoms and clinical features related to DU. Invasive urodynamics is the only widely accepted method for diagnosing DU. In patients with persistently elevated postvoid residual (ie, >300 ml), intermittent catheterization is indicated and preferred to indwelling catheters. Alpha-adrenergic blockers are recommended before more invasive techniques, but the level of evidence is low. In men with DU and concomitant benign prostatic obstruction (BPO), benign prostatic surgery should be considered only after appropriate counseling. In men with DU and no BPO, a test phase of sacral neuromodulation may be considered.</p></div><div><h3>Conclusions and clinical implications</h3><p>The current text represents a summary of the new subchapter on UAB. For more detailed information, refer to the full-text version available on the EAU website (<span><span>https://uroweb.org/guidelines/management-of-non-neurogenic-male-luts</span><svg><path></path></svg></span>).</p></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":25.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140789341","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}
European urologyPub Date : 2024-09-01DOI: 10.1016/j.eururo.2024.06.003
{"title":"Reducing or Increasing Overtreatment? How Do We Measure the Impact of Magnetic Resonance Imaging–targeted Biopsy on Prostate Cancer Mortality?","authors":"","doi":"10.1016/j.eururo.2024.06.003","DOIUrl":"10.1016/j.eururo.2024.06.003","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":25.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433606","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}
European urologyPub Date : 2024-09-01DOI: 10.1016/j.eururo.2024.06.004
{"title":"Biomarkers in Prostate Cancer Screening: Sometimes “More is More”","authors":"","doi":"10.1016/j.eururo.2024.06.004","DOIUrl":"10.1016/j.eururo.2024.06.004","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":25.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428531","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}
European urologyPub Date : 2024-09-01DOI: 10.1016/j.eururo.2024.04.033
{"title":"Re: Michael Baboudjian, Romain Diamand, Alessandro Uleri, et al. Does Overgrading on Targeted Biopsy of Magnetic Resonance Imaging–visible Lesions in Prostate Cancer Lead to Overtreatment? Eur Urol. In press. https://doi.org/10.1016/j.eururo.2024.02.003","authors":"","doi":"10.1016/j.eururo.2024.04.033","DOIUrl":"10.1016/j.eururo.2024.04.033","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":25.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946691","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}
European urologyPub Date : 2024-09-01DOI: 10.1016/j.eururo.2024.06.009
{"title":"Corrigendum to “Androgen Deprivation and Radiotherapy with or Without Docetaxel for Localized High-risk Prostat Cancer: Long-term Follow-up from the Randomized NRG Oncology RTOG 0521 Trial” [Eur. Eurol. 84(2) (2023) 156–163]","authors":"","doi":"10.1016/j.eururo.2024.06.009","DOIUrl":"10.1016/j.eururo.2024.06.009","url":null,"abstract":"<div><h3>Background</h3><p>Intensification of therapy may improve outcomes for patients with high-risk localized prostate cancer.</p></div><div><h3>Objective</h3><p>To provide long-term follow-up data from phase III RTOG 0521, which compared a combination of androgen deprivation therapy (ADT) + external beam radiation therapy (EBRT) + docetaxel with ADT + EBRT.</p></div><div><h3>Design, setting, and participants</h3><p>High-risk localized prostate cancer patients (>50% of patients had Gleason 9–10 disease) were prospectively randomized to 2 yr of ADT + EBRT or ADT + EBRT + six cycles of docetaxel. A total of 612 patients were accrued, and 563 were eligible and included in the modified intent-to-treat analysis.</p></div><div><h3>Outcome measurements and statistical analysis</h3><p>The primary endpoint was overall survival (OS). Analyses with Cox proportional hazards were performed as prespecified in the protocol; however, there was evidence of nonproportional hazards. Thus, a post hoc analysis was performed using the restricted mean survival time (RMST). The secondary endpoints included biochemical failure, distant metastasis (DM) as detected by conventional imaging, and disease-free survival (DFS).</p></div><div><h3>Results and limitations</h3><p>After 10.4 yr of median follow-up among survivors, the hazard ratio (HR) for OS was 0.89 (90% confidence interval [CI] 0.70–1.14; one-sided log-rank <em>p</em> = 0.22). Survival at 10 yr was 64% for ADT + EBRT and 69% for ADT + EBRT + docetaxel. The RMST at 12 yr was 0.45 yr and not statistically significant (one-sided <em>p</em> = 0.053). No differences were detected in the incidence of DFS (HR = 0.92, 95% CI 0.73–1.14), DM (HR = 0.84, 95% CI 0.73–1.14), or prostate-specific antigen recurrence risk (HR = 0.97, 95% CI 0.74–1.29). Two patients had grade 5 toxicity in the chemotherapy arm and zero patients in the control arm.</p></div><div><h3>Conclusions</h3><p>After a median follow-up of 10.4 yr among surviving patients, no significant differences are observed in clinical outcomes between the experimental and control arms. These data suggest that docetaxel should not be used for high-risk localized prostate cancer. Additional research may be warranted using novel predictive biomarkers.</p></div><div><h3>Patient summary</h3><p>No significant differences in survival were noted after long-term follow-up for high-risk localized prostate cancer patients in a large prospective trial where patients were treated with androgen deprivation therapy + radiation to the prostate ± docetaxel.</p></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":25.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0302283824024436/pdfft?md5=d861e2f9cb533b3f943f830ef7d937ca&pid=1-s2.0-S0302283824024436-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428532","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}
European urologyPub Date : 2024-09-01DOI: 10.1016/j.eururo.2024.05.016
{"title":"Reply to Andrew J. Vickers’ Letter to the Editor re: Michael Baboudjian, Romain Diamand, Alessandro Uleri, et al. Does Overgrading on Targeted Biopsy of Magnetic Resonance Imaging–visible Lesions in Prostate Cancer Lead to Overtreatment? Eur Urol. In press. https://doi.org/10.1016/j.eururo.2024.02.003","authors":"","doi":"10.1016/j.eururo.2024.05.016","DOIUrl":"10.1016/j.eururo.2024.05.016","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":25.3,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141134457","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}