European urology最新文献

{"title":"Orthotopic Robot-assisted Kidney Transplantation: Surgical Technique and Preliminary Results","authors":"Francesc Vigués ,&nbsp;Begoña Etcheverry ,&nbsp;José I. Perez Reggeti ,&nbsp;Josep Maria Gaya ,&nbsp;Angelo Territo ,&nbsp;Andrea Gallioli ,&nbsp;Camille Berquin ,&nbsp;Giuseppe Basile ,&nbsp;José F. Suárez ,&nbsp;Maria Fiol ,&nbsp;Oscar Buisan ,&nbsp;Lluís Riera ,&nbsp;Thomas Prudhomme ,&nbsp;Nicolas Doumerc ,&nbsp;Alessio Pecoraro ,&nbsp;Alberto Breda ,&nbsp;European Association of Urology Robotic Urology Section Robot-assisted Kidney Transplantation Working Group","doi":"10.1016/j.eururo.2024.03.037","DOIUrl":"10.1016/j.eururo.2024.03.037","url":null,"abstract":"<div><h3>Background and objective</h3><p>Orthotopic kidney transplantation (KT) has been proposed as an option for patients ineligible for heterotopic KT. In this scenario, orthotopic robot-assisted KT (oRAKT) represents a novel, minimally invasive alternative to the open approach. Here we describe the largest oRAKT series of patients, with a focus on the surgical technique, perioperative surgical outcomes, and functional results.</p></div><div><h3>Methods</h3><p>We queried prospectively maintained databases from three referral centers to identify patients who underwent oRAKT and evaluated surgical and functional outcomes.</p></div><div><h3>Key findings and limitations</h3><p>Overall, 16 oRAKT procedures were performed between January 2020 and August 2023. These involved four donors after cardiovascular death, five donors after brain death, and seven living donors. All oRAKT procedures were carried out in the left renal fossa. The indication for oRAKT was extensive calcification of the external iliac vessels (100%), frequently associated with prior KT (31%). The median operative time was 295 min (interquartile range [IQR] 268–360) and the median rewarming time 48 min (IQR 40–54). Conversion to open surgery occurred in two cases (12%), and delayed graft function was observed in two cases (12%). Postoperative complications occurred in 11 patients (69%) and three (18%) experienced Clavien-Dindo grade &gt;II complications. At median follow-up of 9 mo (IQR 7–17), 14 patients had a functioning graft and median creatinine of 1.49 mg/dl (IQR 1.36–1.72).</p></div><div><h3>Conclusions and clinical implications</h3><p>Although oRAKT is a challenging procedure, it represents a feasible option for individuals ineligible for heterotopic KT and yields favorable perioperative and mid-term functional outcomes.</p></div><div><h3>Patient summary</h3><p>We evaluated outcomes of orthotopic robot-assisted kidney transplantation (KT), in which the native kidney is removed and the donor kidney is transplanted into its place, in patients who are not eligible for heterotopic KT, in which the native kidney is left in place and the donor kidney is transplanted into a new location. We found that robot-assisted surgery is a safe and feasible alternative to traditional open surgery for orthotopic KT.</p></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":23.4,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794581","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":"Congress Calendar","authors":"","doi":"10.1016/j.eururo.2024.03.021","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.03.021","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":23.4,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0302283824022450/pdfft?md5=46f9b324fa11988b2d21f356eecb92b6&pid=1-s2.0-S0302283824022450-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140549464","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":"The Platinum Hall of Fame","authors":"","doi":"10.1016/j.eururo.2024.03.007","DOIUrl":"https://doi.org/10.1016/j.eururo.2024.03.007","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":23.4,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140549506","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: Multi-omic Profiling of Clear Cell Renal Cell Carcinoma Identifies Metabolic Reprogramming Associated with Disease Progression","authors":"Aimin Jiang ,&nbsp;Le Qu ,&nbsp;Chen Cai ,&nbsp;Peng Luo ,&nbsp;Linhui Wang","doi":"10.1016/j.eururo.2024.04.001","DOIUrl":"10.1016/j.eururo.2024.04.001","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":23.4,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774178","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":"Summary of the 2024 Update of the European Association of Urology Guidelines on Neurourology","authors":"Andrea M. Sartori ,&nbsp;Thomas M. Kessler ,&nbsp;David M. Castro-Díaz ,&nbsp;Peter de Keijzer ,&nbsp;Giulio Del Popolo ,&nbsp;Hazel Ecclestone ,&nbsp;Dennis Frings ,&nbsp;Jan Groen ,&nbsp;Rizwan Hamid ,&nbsp;Gilles Karsenty ,&nbsp;Stefania Musco ,&nbsp;Bárbara Padilla-Fernández ,&nbsp;Jürgen Pannek ,&nbsp;Natasha Schouten ,&nbsp;Angela van der Vorm ,&nbsp;Bertil F.M. Blok","doi":"10.1016/j.eururo.2024.03.026","DOIUrl":"10.1016/j.eururo.2024.03.026","url":null,"abstract":"<div><h3>Background and objective</h3><p>Most patients with neurourological disorders require lifelong medical care. The European Association of Urology (EAU) regularly updates guidelines for diagnosis and treatment of these patients. The objective of this review is to provide a summary of the 2024 updated EAU guidelines on neurourology.</p></div><div><h3>Methods</h3><p>A structured literature review covering the timeframe 2021–2023 was conducted for the guideline update. A level of evidence and a strength rating were assigned for each recommendation on the basis of the literature data.</p></div><div><h3>Key findings and limitations</h3><p>Neurological conditions significantly affect urinary, sexual, and bowel function, and lifelong management is required for neurourological patients to maintain their quality of life and prevent urinary tract deterioration. Early diagnosis and effective treatment are key, and comprehensive clinical assessments, including urodynamics, are crucial. Management should be customised to individual needs and should involve a multidisciplinary approach and address sexuality and fertility. Lifelong monitoring and follow-up highlight the importance of continuous care for neurourological patients.</p></div><div><h3>Conclusions and clinical implications</h3><p>The 2024 EAU guidelines on neurourology provide an up-to-date overview of available evidence on diagnosis, treatment, and follow-up for neurourological patients.</p></div><div><h3>Patient summary</h3><p>Neurological disorders very frequently affect the lower urinary tract and sexual and bowel function and patients need lifelong management. We summarise the updated European Association of Urology guidelines on neurourology to provide patients and caregivers with the latest insights for optimal health care support.</p></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":23.4,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140794618","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 Responses to Lenvatinib plus Pembrolizumab in Patients with Advanced Renal Cell Carcinoma at the Final Prespecified Survival Analysis of the Phase 3 CLEAR Study","authors":"Robert J. Motzer ,&nbsp;Toni K. Choueiri ,&nbsp;Thomas Hutson ,&nbsp;Sun Young Rha ,&nbsp;Javier Puente ,&nbsp;Aly-Khan A. Lalani ,&nbsp;Eric Winquist ,&nbsp;Masatoshi Eto ,&nbsp;Naveen S. Basappa ,&nbsp;Nizar M. Tannir ,&nbsp;Ulka Vaishampayan ,&nbsp;Georg A. Bjarnason ,&nbsp;Stéphane Oudard ,&nbsp;Viktor Grünwald ,&nbsp;Joseph Burgents ,&nbsp;Ran Xie ,&nbsp;Jodi McKenzie ,&nbsp;Thomas Powles","doi":"10.1016/j.eururo.2024.03.015","DOIUrl":"10.1016/j.eururo.2024.03.015","url":null,"abstract":"<div><p>In the phase 3 CLEAR trial, lenvatinib plus pembrolizumab (L + P) showed superior efficacy versus sunitinib in treatment-naïve patients with advanced renal cell carcinoma (aRCC). The combination treatment was associated with a robust objective response rate of 71%. Here we report tumor responses for patients in the L + P arm in CLEAR, with median follow-up of ∼4 yr at the final prespecified overall survival (OS) analysis. Tumor responses were assessed by independent review using Response Evaluation Criteria in Solid Tumors v1.1. Patients with a complete response (CR; <em>n</em> = 65), partial response (PR) with maximum tumor shrinkage ≥75% (near-CR; <em>n</em> = 59), or PR with maximum tumor shrinkage &lt;75% (other PR; <em>n</em> = 129), were characterized in terms of their baseline characteristics. The median duration of response was 43.7 mo (95% confidence interval [CI] 39.2–not estimable) for the CR group, 30.5 mo (95% CI 22.4–not estimable) for the near-CR group, and 17.2 mo (95% CI 12.5–21.4) for the other PR group. The 36-mo OS rates were consistently high in the CR (97%), near-CR (86%), and other PR (62%) groups. Robust objective response rates were observed across International Metastatic RCC Database Consortium favorable-risk (69%, 95% CI 60–78%), intermediate-risk (73%, 95% CI 67–79%), and poor-risk (70%, 95% CI 54–85%) subgroups. The robust response to L + P supports this combination as a standard-of-care first-line treatment for patients with aRCC.</p></div><div><h3>Patient summary</h3><p>The CLEAR trial enrolled patients with advanced kidney cancer who had not previously received any treatment for their cancer. Here we report results for tumor shrinkage observed in the group that received lenvatinib plus pembrolizumab combination treatment during the trial. Shrinkage of target tumors with this combination was long-lasting and was observed in patients irrespective of their disease severity.</p><p>This trial is registered on ClinicalTrials.gov as NCT02811861.</p></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":23.4,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0302283824022346/pdfft?md5=0e7ba310a3003c21449dc85a9f954d54&pid=1-s2.0-S0302283824022346-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140765769","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":"Re: Bertrand Tombal, Sean Collins, Alicia K. Morgans, et al. Impact of Relugolix Versus Leuprolide on the Quality of Life of Men with Advanced Prostate Cancer: Results from the Phase 3 HERO Study. Eur Urol 2023;84:579–87","authors":"Hannah L. Rush ,&nbsp;Duncan C. Gilbert ,&nbsp;Ruth E. Langley","doi":"10.1016/j.eururo.2024.03.024","DOIUrl":"10.1016/j.eururo.2024.03.024","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":23.4,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140735624","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: Giuseppe Basile, Giuseppe Fallara, Paolo Verri, et al. The Role of 99mTc-Sestamibi Single-photon Emission Computed Tomography/Computed Tomography in the Diagnostic Pathway for Renal Masses: A Systematic Review and Meta-analysis. Eur Urol 2024;85:63–71","authors":"Angela Estevez,&nbsp;Phillip Kim,&nbsp;Peter Chang,&nbsp;Andrew A. Wagner","doi":"10.1016/j.eururo.2024.02.026","DOIUrl":"10.1016/j.eururo.2024.02.026","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":23.4,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140788711","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 Angela Estevez, Phillip Kim, Peter Chang, and Andrew A. Wagner’s Letter to the Editor re: Giuseppe Basile, Giuseppe Fallara, Paolo Verri, et al. The Role of 99mTc-Sestamibi Single-photon Emission Computed Tomography/Computed Tomography in the Diagnostic Pathway for Renal Masses: A Systematic Review and Meta-analysis. Eur Urol 2024;85:63–71","authors":"Giuseppe Basile ,&nbsp;Alessandro Larcher ,&nbsp;Arturo Chiti ,&nbsp;Alberto Breda ,&nbsp;Umberto Capitanio","doi":"10.1016/j.eururo.2024.03.022","DOIUrl":"10.1016/j.eururo.2024.03.022","url":null,"abstract":"","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":23.4,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874183","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 Radiotherapy in Low-volume Metastatic Hormone-sensitive Prostate Cancer: A Network Meta-analysis","authors":"Soumyajit Roy ,&nbsp;Gagan Fervaha ,&nbsp;Daniel E. Spratt ,&nbsp;Yilun Sun ,&nbsp;Amar U. Kishan ,&nbsp;Andrew Loblaw ,&nbsp;Shawn Malone ,&nbsp;Michael Ong ,&nbsp;Fred Saad ,&nbsp;Christopher J.D. Wallis ,&nbsp;Scott C. Morgan","doi":"10.1016/j.eururo.2024.03.018","DOIUrl":"10.1016/j.eururo.2024.03.018","url":null,"abstract":"<div><h3>Background and objective</h3><p>The utility of prostate radiotherapy (RT) is unclear in men with metastatic hormone-sensitive prostate cancer (mHSPC) receiving intensified systemic therapy with androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs). We performed a network meta-analysis of randomized controlled trials (RCTs) to investigate the role of prostate RT in low-volume mHSPC.</p></div><div><h3>Methods</h3><p>Bibliographic databases and conference proceedings were searched through July 2023 for RCTs evaluating the addition of ARPIs or prostate RT to standard of care (SOC) systemic therapy, defined as ADT or ADT plus docetaxel, for the initial treatment of mHSPC. We focused exclusively on aggregate data from the low-volume mHSPC subpopulation in these trials. We pooled the treatment arms into four groups: SOC, SOC plus ARPI, SOC plus RT, and SOC plus ARPI plus RT. The primary outcome was overall survival (OS). To compare treatment strategies, a fixed-effects Bayesian network meta-analysis was undertaken, while a Bayesian network meta-regression was performed to account for across-trial differences in docetaxel use as part of SOC and in proportions of patients with de novo presentation.</p></div><div><h3>Key findings and limitations</h3><p>Ten RCTs comprising 4423 patients were eligible. The Surface Under the Cumulative Ranking Curve scores were 0.0006, 0.45, 0.62, and 0.94 for SOC, SOC plus RT, SOC plus ARPI, and SOC plus ARPI plus RT, respectively. On a meta-regression, in a population with de novo mHSPC and no docetaxel use, we did not find sufficient evidence of a difference in OS between SOC plus ARPI plus RT versus SOC plus ARPI (hazard ratio [HR]: 0.76; 95% credible interval: 0.51–1.16) and SOC plus RT versus SOC plus ARPI (HR: 1.10; 95% credible interval: 0.92–1.42).</p></div><div><h3>Conclusions and clinical implications</h3><p>There was some evidence that SOC plus ARPI plus RT reduced mortality compared with the next best strategy of SOC plus ARPI in patients with low-volume de novo mHSPC. A meta-analysis with individual patient data or an RCT is needed to confirm these findings.</p></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":23.4,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0302283824022395/pdfft?md5=103d51cec4daf332e16f9eda9dce73a6&pid=1-s2.0-S0302283824022395-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140797238","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}